Individual provider Active NPI

Clementine Ingabire, D.D.S

  • Dentist
  • Houston, TX
National Provider Identifier
1235481102
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26290 Issued in TX
Practice address
4040 Airport Blvd
Houston, TX 77047-1158
Phone
(713) 738-1999
Fax
(713) 738-2085
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 26290 TX Primary

Addresses

Primary practice location

4040 Airport Blvd
Houston, TX 77047-1158

Mailing address

4040 Airport Blvd
Houston, TX 77047-1158
Phone (713) 738-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161005000647 TX Practitioner - Oral Surgery 3476841560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26290TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F Austin Community Health Center,Inc CurrentSince Jul 9, 2016 Accepting new patients
Stephen F. Austin Community Health Center, Inc. CurrentSince Jul 9, 2016 Accepting new patients
Jyron Walls ,DDS Past Accepting new patients
Sleep Well Sunnyside PastSince Apr 20, 2025 Accepting new patients
Utmb Faculty Group Practice Past Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1235481102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 AIRPORT BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471158",
            "telephone_number": "713-738-1999",
            "fax_number": "713-738-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 AIRPORT BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471158",
            "telephone_number": "713-738-1999",
            "fax_number": "713-738-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGABIRE",
        "first_name": "CLEMENTINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "26290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.