Individual provider Active NPI

Roshan Roshannejad, DDS-MS

  • Pediatric Dentistry
  • New Caney, TX
National Provider Identifier
1679920631
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
32518 Issued in TX
Practice address
22118 Market Place Dr Ste 500
New Caney, TX 77357-2165
Phone
(832) 930-7732
NPI assigned
May 19, 2016
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 32518 TX Primary

Addresses

Primary practice location

22118 Market Place Dr Ste 500
New Caney, TX 77357-2165

Mailing address

22118 Market Place Dr Ste 500
New Caney, TX 77357-2165
Phone (832) 930-7732

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
I20170321000986 TX Order and Referring Only - DentistPractitioner - Dentist 8224313952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32518TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Kids Pediatric Dentistry, PLLC Pediatric Dentistry CurrentSince May 26, 2024 Accepting new patients
Unique Kids PD-Lake Houston, PLLC Pediatric Dentistry CurrentSince Sep 8, 2024 Accepting new patients

Locations

22118 Market Place Dr
Ste 500
New Caney, TX 77357
Phone (832) 930-7732

Organizations & group practices 2

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1679920631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22118 MARKET PLACE DR STE 500",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773572165",
            "telephone_number": "832-930-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22118 MARKET PLACE DR STE 500",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773572165",
            "telephone_number": "832-930-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHANNEJAD",
        "first_name": "ROSHAN",
        "name_prefix": "Dr.",
        "credential": "DDS-MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "32518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Caney, TX

Sources for this page

Verify at the official NPI Registry.