ADRIAN KARIM RUIZ ROCHA — NPI 1366993289 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in TIJUANA, BAJA CALIFORNIA)

CMS-1500 Box 24J / 33a • NPI

1366993289

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

122300000X (CMS C5)

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

Box 32 Service Location & ZIP+4

PASEO DE LOS HEROES # 9250, ZONA URBANA RIO, TIJUANA, BAJA CALIFORNIA, 22320

Official NPPES Practice Location

Practice Phone & Referral Fax

(619) 488-2566

Fax: (866) 272-6924

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366993289 (ADRIAN KARIM RUIZ ROCHA) 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	`1366993289` (NPI-2 Organization / Facility)
Provider / Legal Name	ADRIAN KARIM RUIZ ROCHA
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `122300000X` (Dentist)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	PASEO DE LOS HEROES # 9250, ZONA URBANA RIO, TIJUANA, BAJA CALIFORNIA, 22320
Practice Telephone / Fax	Tel: (619) 488-2566 \| Fax: (866) 272-6924
Administrative Mailing Address	4275 EXECUTIVE SQ, LA JOLLA, CA, 92037-9123
Enumeration & Last Sync	Enumerated: 2016-10-14 \| CMS Record Updated: 2016-10-14
Authorized Official	ADRIAN RUIZ ROCHA (Dentist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

PASEO DE LOS HEROES # 9250, ZONA URBANA RIO, TIJUANA, BAJA CALIFORNIA, 22320

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Plain-English Taxonomy & CMS Crosswalk (122300000X)

What Does Taxonomy Code 122300000X Mean?

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

CMS-1500 Medicare Specialty Crosswalk: CMS Code C5 (Dentist)
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 (ADRIAN KARIM RUIZ ROCHA)

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
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: ZZ \| License: `8144023` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADRIAN KARIM RUIZ ROCHA (NPI #1366993289)