Rodney K Rayburn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11761 Issued in TX

Practice address

4910 Willowbend Blvd
Suite-C
Houston, TX 77035-3222

Phone

(713) 729-1813

Fax

(713) 729-6080

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Legacy Dental Group, PLLC

  • Dentist
  • Houston, TX
  • NPI 1730646571
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669474094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 WILLOWBEND BLVD",
            "address_2": "SUITE-C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770353227",
            "telephone_number": "713-729-1813",
            "fax_number": "713-729-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 WILLOWBEND BLVD",
            "address_2": "SUITE-C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770353222",
            "telephone_number": "713-729-1813",
            "fax_number": "713-729-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "RODNEY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "11761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suhani Ray, APRN
• Shrisa Rayachhetry
• Sidney Rayas, RBT
• Debby Denise Raybon, FNP-BC
• Cari Hampton Rayborn, MD
• Sarah Raye
• Zaria Rayes
• Rayford Dental
• Aaron Rayford, PA-C
• Clayton Rayford, CRNA

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.