CMS-1500 Box 24J / 33a • NPI
1639585821
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
390200000X
Licensed & Credentialed Student in an Organized Health Care Education/Training Program
Box 32 Service Location & ZIP+4
29 BOKUM RD, CHESTER, CT, 06412-1339
✓ 9-Digit EDI 837 ZIP+4 (06412-1339)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1639585821 (JESSICA DOMINIQUE BRUCE, DMD) 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 | 1639585821 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JESSICA DOMINIQUE BRUCE, DMD |
| Plain-English Specialty | Licensed & Credentialed Student in an Organized Health Care Education/Training Program NUCC Code: 390200000X (Student in an Organized Health Care Education/Training Program) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 29 BOKUM RD, CHESTER, CT, 06412-1339 |
| Practice Telephone / Fax | Tel: (860) 559-9146 |
| Administrative Mailing Address | 29 BOKUM RD, CHESTER, CT, 06412-1339 |
| Enumeration & Last Sync | Enumerated: 2014-07-08 | CMS Record Updated: 2022-08-26 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (390200000X)
What Does Taxonomy Code 390200000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 390200000X translates to:
"Licensed & Credentialed Student in an Organized Health Care Education/Training Program"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JESSICA DOMINIQUE BRUCE, DMD)
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
- 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 |
|---|---|
122300000X — DentistPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CT | License: 2.011701 | Primary: Secondary |
1223P0221X — Dentist, Pediatric DentistryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CT | License: 11701 | Primary: Secondary |
390200000X — Student in an Organized Health Care Education/Training ProgramPlain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program | State: CT | License: 11701 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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