CMS-1500 Box 24J / 33a • NPI
1558327684
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
1223E0200X
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
546 S BROAD ST SUITE 3B, MERIDEN, CT, 06650
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1558327684 (ADVANCED ENDODONTICS OF CT PC) 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 | 1558327684 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED ENDODONTICS OF CT PC |
| Plain-English Specialty | Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: 1223E0200X (Dentist, Endodontics) |
| Certifying / Licensing Body | American Dental Association (ADA) / State Board of Dental Examiners |
| Practice Location Address | 546 S BROAD ST SUITE 3B, MERIDEN, CT, 06650 |
| Practice Telephone / Fax | Tel: (203) 237-7449 | Fax: (203) 237-1234 |
| Administrative Mailing Address | 546 S BROAD STREET, MERIDEN, CT, 06450 |
| Enumeration & Last Sync | Enumerated: 2006-04-26 | CMS Record Updated: 2020-08-22 |
| Authorized Official | KENNETH CHASEN (President) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (1223E0200X)
What Does Taxonomy Code 1223E0200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223E0200X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED ENDODONTICS OF CT PC)
Typical CPT / Diagnostic Procedures:- Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
- Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions
- 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 |
|---|---|
1223E0200X — Dentist, EndodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CT | License: 4689 | Primary: Secondary |
1223E0200X — Dentist, EndodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CT | License: 9031 | Primary: Secondary |
1223E0200X — Dentist, EndodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CT | License: 7884 | Primary: Yes (Primary) |
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