DR. BRADLEY PITTMAN DDS LTD. — NPI 1306743885 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in WAUSEON, OH)

CMS-1500 Box 24J / 33a • NPI

1306743885

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1223S0112X (CMS 19)

Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)

Box 32 Service Location & ZIP+4

447 N SHOOP AVE, WAUSEON, OH, 43567-1261

✓ 9-Digit EDI 837 ZIP+4 (43567-1261)

Practice Phone & Referral Fax

(419) 335-7888

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1306743885 (DR. BRADLEY PITTMAN DDS LTD.) 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	`1306743885` (NPI-2 Organization / Facility)
Provider / Legal Name	DR. BRADLEY PITTMAN DDS LTD.
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `1223S0112X` (Dentist, Oral and Maxillofacial Surgery)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	447 N SHOOP AVE, WAUSEON, OH, 43567-1261
Practice Telephone / Fax	Tel: (419) 335-7888
Administrative Mailing Address	447 N SHOOP AVE, WAUSEON, OH, 43567-1261
Enumeration & Last Sync	Enumerated: 2026-10-20 \| CMS Record Updated: 2026-10-20
Authorized Official	MICHAELA MUNIZ (VP, Payor Relations)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

447 N SHOOP AVE, WAUSEON, OH, 43567-1261

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Plain-English Taxonomy & CMS Crosswalk (1223S0112X)

What Does Taxonomy Code 1223S0112X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223S0112X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 19 (Oral Surgery (Dentist only))
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DR. BRADLEY PITTMAN DDS LTD.)

Typical CPT / Diagnostic Procedures:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1223S0112X` — Dentist, Oral and Maxillofacial Surgery Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`204E00000X` — Oral & Maxillofacial Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery	State: N/A \| License: `Verified` \| Primary: Secondary

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DR. BRADLEY PITTMAN DDS LTD. (NPI #1306743885)