Milad Koosha

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

112280 Issued in CA

Practice address

345 E 24TH St
New York, NY 10010-4020

Phone

(212) 998-9800

NPI assigned

Jun 30, 2023

Last updated

Sep 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maryam Waheed Dental Group Corp

  • General Practice Dentistry
  • Lake Forest, CA
  • NPI 1932676699
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1366129439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22373 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305053",
            "telephone_number": "949-444-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E 24TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104020",
            "telephone_number": "212-998-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22373 El Toro Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926305053",
            "country_code": "US",
            "telephone_number": "949-444-5833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOSHA",
        "first_name": "MILAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "112280",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Koonin, PSY.D.
• Meryl Koopersmith, MSSW LCSW
• Alysha Koorji
• Richard Koos, C.R.N.A.
• Victoria Markovits Koos, L.AC. MTOM
• Maryam Kooshesh, MD
• Koova Management LLC
• Marcy Kopakin, LCSW
• Nicole Dolores Kopchak, PA
• Melissa Ann Kopchynski

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.