Individual provider Active NPI

Roshanak Momen

  • Endodontics
  • Mission Viejo, CA
National Provider Identifier
1255785408
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
100152 Issued in CA
Practice address
26302 La Paz Rd Ste 210
Mission Viejo, CA 92691-5328
Phone
(949) 818-4884
NPI assigned
Apr 13, 2016
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 100152 CA Primary

Addresses

Primary practice location

26302 La Paz Rd Ste 210
Mission Viejo, CA 92691-5328

Mailing address

26302 La Paz Rd Ste 210
Mission Viejo, CA 92691-5328
Phone (949) 818-4884

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

LicenseStateTypeSpecialty
100152CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Roshanak Momen Dental Inc Endodontics CurrentSince Jun 8, 2025 Accepting new patients

Locations

26302 La Paz Rd
Ste 210
Mission Viejo, CA 92691
Phone (949) 448-7667

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1255785408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ RD STE 210",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915328",
            "telephone_number": "949-818-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ RD STE 210",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915328",
            "telephone_number": "949-818-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMEN",
        "first_name": "ROSHANAK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "100152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.