βœ“ Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) (122300000X)

1075 S. PEORIA LLC (NPI #1265851042)

Dentist • AURORA, CO • Status: Active Federal Registration

Plain-English Taxonomy Translation (122300000X)

What Does Taxonomy Code 122300000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 122300000X translates in plain language to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

Primary Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
When Patients Should Consult: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

CMS Medicare Utilization & Part D Prescribing Benchmarks

Common Procedures & Clinical Prescribing Profile

Typical clinical procedures (Medicare Part B Utilization) and therapeutic classes (Medicare Part D Prescribing) associated with 1075 S. PEORIA LLC:

High-Volume Clinical Procedures & Diagnostics:
  • Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
  • Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions
Common Therapeutic & Prescribing Classes:
  • Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
  • Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number1265851042 (NPI-2 Organization / Facility)
Provider / Legal Name1075 S. PEORIA LLC
Plain-English SpecialtyLicensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
NUCC Code: 122300000X (Dentist)
Certifying / Licensing BodyAmerican Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address1075 S PEORIA ST, AURORA, CO, 800123413
Practice Telephone / FaxTel: 303-341-4878
Administrative Mailing Address1075 S PEORIA ST, AURORA, CO, 800123413
Enumeration & Last SyncEnumerated: 2014-04-09 | Updated: 2014-04-09
Authorized OfficialSEUNG LEE (owner)

Clinic Location, Accessibility & Directions

πŸ“ Practice Location & Patient Access

1075 S PEORIA ST, AURORA, CO, 800123413

πŸ—ΊοΈ Open in Google Maps & Parking βš™οΈ View Enriched JSON API

ADA & HIPAA Verification Note: Practice locations registered as primary LOCATION addresses under CMS NPPES are clinical service delivery sites (distinct from billing/mailing addresses).

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All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English DescriptionState License & Primary Status
122300000X β€” Dentist
Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
State: CO | License: 9056 | Primary Taxonomy: Secondary
122300000X β€” Dentist
Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
State: CO | License: 7478 | Primary Taxonomy: Yes