Provider Demographics
NPI:1225614118
Name:MASOOD, HAROON A (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAROON
Middle Name:A
Last Name:MASOOD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 CATALINA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-4707
Mailing Address - Country:US
Mailing Address - Phone:408-206-0751
Mailing Address - Fax:
Practice Address - Street 1:3269 STEELYARD DR # K-7
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-2381
Practice Address - Country:US
Practice Address - Phone:440-822-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13104390200000X
390200000X
OH30.0269031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program