ADAMS MICRO ENDODONTICS INC — NPI 1720755804 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in LA MESA, CA)

CMS-1500 Box 24J / 33a • NPI

1720755804

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

8860 CENTER DR STE 430, LA MESA, CA, 91942-7001

✓ 9-Digit EDI 837 ZIP+4 (91942-7001)

Practice Phone & Referral Fax

(619) 510-3566

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1720755804 (ADAMS MICRO ENDODONTICS INC) 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	`1720755804` (NPI-2 Organization / Facility)
Provider / Legal Name	ADAMS MICRO ENDODONTICS INC
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	8860 CENTER DR STE 430, LA MESA, CA, 91942-7001
Practice Telephone / Fax	Tel: (619) 510-3566
Administrative Mailing Address	8860 CENTER DR STE 430, LA MESA, CA, 91942-7001
Enumeration & Last Sync	Enumerated: 2021-08-25 \| CMS Record Updated: 2023-06-20
Authorized Official	MONA ADAMS (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

8860 CENTER DR STE 430, LA MESA, CA, 91942-7001

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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)"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
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 (ADAMS MICRO ENDODONTICS INC)

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
`1223E0200X` — Dentist, Endodontics Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADAMS MICRO ENDODONTICS INC (NPI #1720755804)