Healthcare Provider Details
I. General information
NPI: 1033255906
Provider Name (Legal Business Name): TODD EDWARD SUMNER DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8937 LA ENTRADA AVE
WHITTIER CA
90605-1711
US
IV. Provider business mailing address
8937 LA ENTRADA AVE
WHITTIER CA
90605-1711
US
V. Phone/Fax
- Phone: 562-698-0943
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | 58935 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0106X |
| Taxonomy | Oral and Maxillofacial Pathology Dentistry |
| License Number | S2-186C |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: