Healthcare Provider Details

I. General information

NPI: 1801727581
Provider Name (Legal Business Name): MASOUD MILANI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 XIMENO AVE
LONG BEACH CA
90815-2850
US

IV. Provider business mailing address

1835 XIMENO AVE
LONG BEACH CA
90815-2850
US

V. Phone/Fax

Practice location:
  • Phone: 562-453-1111
  • Fax:
Mailing address:
  • Phone: 562-453-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112967
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: