Active NPI
Samir K Momin, DDS
- Dentist
- Austin, TX
National Provider Identifier
1619259934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 27233
- Practice address
- 1000 E 41St Street
Suite 230
Austin, TX 78751 - Phone
- (512) 458-3600
- Fax
- (512) 458-3033
- NPI assigned
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27233 | TX | Primary |
Addresses
Primary practice location
1000 E 41St Street
Suite 230
Austin, TX 78751
Mailing address
6280 McNeil Dr Apt 513
Austin, TX 78729-6908
Phone (512) 740-1435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150710002051 | CA | Order and Referring Only - Dentist | 9739491242 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27233 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twinsca, PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Cedar Park, TX
- NPI 1508270166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1619259934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6280 MCNEIL DR APT 513",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787296908",
"telephone_number": "512-740-1435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E 41ST STREET",
"address_2": "SUITE 230",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78751",
"telephone_number": "512-458-3600",
"fax_number": "512-458-3033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMIN",
"first_name": "SAMIR",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "27233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.