Healthcare Provider Details

I. General information

NPI: 1417851841
Provider Name (Legal Business Name): MASUDIAN DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23101 SHERMAN PL STE 415
WEST HILLS CA
91307-2037
US

IV. Provider business mailing address

23101 SHERMAN PL STE 415
WEST HILLS CA
91307-2037
US

V. Phone/Fax

Practice location:
  • Phone: 818-877-0118
  • Fax:
Mailing address:
  • Phone: 818-877-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MOHAMMAD MASUDIAN
Title or Position: OWNER
Credential: DDS, MPH
Phone: 818-877-0118