CMS-1500 Box 24J / 33a • NPI
1871827048
Type 1 Individual Rendering/Ordering
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
221 3RD ST W, RANDOLPH AFB, TX, 78150-4800
✓ 9-Digit EDI 837 ZIP+4 (78150-4800)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1871827048 (JENARA LEIGH ALLEN, DDS) 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 | 1871827048 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JENARA LEIGH ALLEN, DDS |
| 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 | 221 3RD ST W, RANDOLPH AFB, TX, 78150-4800 |
| Practice Telephone / Fax | Tel: (210) 652-6403 |
| Administrative Mailing Address | 15301 WARREN SHINGLE RD, BEALE AFB, CA, 95903-1907 |
| Enumeration & Last Sync | Enumerated: 2009-09-21 | CMS Record Updated: 2021-04-28 |
Clinic Location, Accessibility & Directions
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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)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JENARA LEIGH ALLEN, DDS)
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 |
|---|---|
1223G0001X — Dentist, General PracticePlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CA | License: 58837 | Primary: Secondary |
122300000X — DentistPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CA | License: 58837 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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