Active NPI
Mohammad Masudian, DDS, MPH
- Dentist
- Goldendale, WA
National Provider Identifier
1588425169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61488363
- Practice address
- 310 S Roosevelt St
Goldendale, WA 98620-9201 - Phone
- (509) 773-4022
- NPI assigned
- Jan 19, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orofacial Pain Dentistry | 1223X2210X | 112490 | CA | |
| Dentist | 122300000X | 40350 | TX | |
| Orofacial Pain Dentistry | 1223X2210X | DE61488363 | WA | |
| Orofacial Pain Dentistry | 1223X2210X | 40350 | TX | |
| Dentist | 122300000X | DE61488363 | WA | Primary |
| Dentist | 122300000X | 112490 | CA |
Addresses
Primary practice location
310 S Roosevelt St
Goldendale, WA 98620-9201
Mailing address
PO Box 1619
Goldendale, WA 98620-1619
Phone (419) 322-0598
Other names 1
- Dr. Mohammad Masoudian Khouzani
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112490 | CA | MD | Dentist |
| DE61488363 | WA | MD | Orofacial Pain Dentist |
| 40350 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774742400000",
"number": "1588425169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1619",
"city": "GOLDENDALE",
"state": "WA",
"postal_code": "986201619",
"telephone_number": "419-322-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 S ROOSEVELT ST",
"city": "GOLDENDALE",
"state": "WA",
"postal_code": "986209201",
"telephone_number": "509-773-4022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASUDIAN",
"first_name": "MOHAMMAD",
"name_prefix": "Dr.",
"credential": "DDS, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-19",
"last_updated": "2026-03-29",
"certification_date": "2026-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223X2210X",
"taxonomy_group": "",
"desc": "Dentist, Orofacial Pain",
"state": "CA",
"license": "112490",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "40350",
"primary": false
},
{
"code": "1223X2210X",
"taxonomy_group": "",
"desc": "Dentist, Orofacial Pain",
"state": "WA",
"license": "DE61488363",
"primary": false
},
{
"code": "1223X2210X",
"taxonomy_group": "",
"desc": "Dentist, Orofacial Pain",
"state": "TX",
"license": "40350",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE61488363",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "112490",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MOHAMMAD",
"last_name": "MASOUDIAN KHOUZANI",
"prefix": "DR.",
"credential": "DDS, MPH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Goldendale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.