MEDICARE: LANGROODI DENTAL PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1770147670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANGROODI DENTAL PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	99 N SAN ANTONIO AVE STE 220
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4578
Country	:	US
Telephone Number	:	310-993-2798
Fax Number	:

Provider Business Practice Location Address
First Line	:	5461 HOLT BLVD
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-4500
Country	:	US
Telephone Number	:	909-983-6888
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HOUMAN LANGROODI
Credential	:	DDS
Telephone Number	:	310-993-2798

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	01/02/2026

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