Individual provider Active NPI

Rohail Ruknuddin Momin, DDS

  • Dentist
  • Houston, TX
National Provider Identifier
1720751126
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37505 Issued in TX
Practice address
5357 W Bellfort St
Houston, TX 77035-3001
Phone
(713) 325-5098
NPI assigned
Jul 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 37505 TX Primary

Addresses

Primary practice location

5357 W Bellfort St
Houston, TX 77035-3001

Mailing address

3814 Windmill Links Dr
Richmond, TX 77407-3272
Phone (832) 782-3967

Other practice location 1

5620 Cypress Creek Pkwy
Houston, TX 77069-4202
Phone (281) 880-9469

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
I20210901003061 TX Order and Referring Only - DentistPractitioner - Dentist 4183020050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37505TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Champions Modern Dentistry, PC PastSince Aug 1, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1720751126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 WINDMILL LINKS DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774073272",
            "telephone_number": "832-782-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5357 W BELLFORT ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770353001",
            "telephone_number": "713-325-5098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5620 Cypress Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770694202",
            "country_code": "US",
            "telephone_number": "281-880-9469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "ROHAIL",
        "middle_name": "RUKNUDDIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-30",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "37505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.