DALLAS AVENUE DENTAL CARE, INC. — NPI 1255769535 (Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment in MENA, AR)

CMS-1500 Box 24J / 33a • NPI

1255769535

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

332BC3200X

Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment

Box 32 Service Location & ZIP+4

400 PINE AVE, MENA, AR, 71953-4604

✓ 9-Digit EDI 837 ZIP+4 (71953-4604)

Practice Phone & Referral Fax

(479) 394-7800

Fax: (479) 394-7803

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1255769535 (DALLAS AVENUE DENTAL CARE, INC.) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1255769535` (NPI-2 Organization / Facility)
Provider / Legal Name	DALLAS AVENUE DENTAL CARE, INC.
Plain-English Specialty	Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment NUCC Code: `332BC3200X` (Durable Medical Equipment & Medical Supplies, Customized Equipment)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	400 PINE AVE, MENA, AR, 71953-4604
Practice Telephone / Fax	Tel: (479) 394-7800 \| Fax: (479) 394-7803
Administrative Mailing Address	400 PINE AVE, MENA, AR, 71953-4604
Enumeration & Last Sync	Enumerated: 2013-10-23 \| CMS Record Updated: 2013-10-23
Authorized Official	DIANE MAROSY (owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

400 PINE AVE, MENA, AR, 71953-4604

🗺️ Open in Google Maps 🏥 More Providers in MENA

🔒 Are you DALLAS AVENUE DENTAL CARE, INC.? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (332BC3200X)

What Does Taxonomy Code 332BC3200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 332BC3200X translates to:
"Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Durable Medical Equipment & Medical Supplies, Customized Equipment for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DALLAS AVENUE DENTAL CARE, INC.)

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

Common Therapeutic Classes:

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
`332BC3200X` — Durable Medical Equipment & Medical Supplies, Customized Equipment Plain English: Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment	State: AR \| License: `2933` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

DALLAS AVENUE DENTAL CARE, INC. (NPI #1255769535)