CMS-1500 Box 24J / 33a • NPI
1063911923
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
204E00000X (CMS 02)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery
Box 32 Service Location & ZIP+4
500 CONGRESS ST STE 3D, QUINCY, MA, 02169-0917
✓ 9-Digit EDI 837 ZIP+4 (02169-0917)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1063911923 (FAITH T AJIBOYE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1063911923 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | FAITH T AJIBOYE |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery NUCC Code: 204E00000X (Oral & Maxillofacial Surgery) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 500 CONGRESS ST STE 3D, QUINCY, MA, 02169-0917 |
| Practice Telephone / Fax | Tel: (617) 773-9900 |
| Administrative Mailing Address | 500 CONGRESS ST STE 3D, QUINCY, MA, 02169-0917 |
| Enumeration & Last Sync | Enumerated: 2018-02-06 | CMS Record Updated: 2025-11-24 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (204E00000X)
What Does Taxonomy Code 204E00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 204E00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (FAITH T AJIBOYE)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
204E00000X — Oral & Maxillofacial SurgeryPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery | State: MA | License: DN10000081 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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