CMS-1500 Box 24J / 33a • NPI
1891865507
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
126800000X
Licensed & Credentialed Dental Assistant
Box 32 Service Location & ZIP+4
5005 STATE RD, ASHTABULA, OH, 44004-6265
✓ 9-Digit EDI 837 ZIP+4 (44004-6265)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1891865507 (ASHTABULA DENTAL ASSOCIATES, 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1891865507 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ASHTABULA DENTAL ASSOCIATES, INC. |
| Plain-English Specialty | Licensed & Credentialed Dental Assistant NUCC Code: 126800000X (Dental Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 5005 STATE RD, ASHTABULA, OH, 44004-6265 |
| Practice Telephone / Fax | Tel: (440) 992-3146 | Fax: (440) 998-6932 |
| Administrative Mailing Address | 5005 STATE RD, ASHTABULA, OH, 44004-6265 |
| Enumeration & Last Sync | Enumerated: 2006-11-09 | CMS Record Updated: 2025-09-11 |
| Authorized Official | WILLIAM SOCKMAN (President) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (126800000X)
What Does Taxonomy Code 126800000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 126800000X translates to:
"Licensed & Credentialed Dental Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ASHTABULA DENTAL ASSOCIATES, INC.)
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 |
|---|---|
1223E0200X — Dentist, EndodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: N/A | License: Verified | Primary: Secondary |
1223G0001X — Dentist, General PracticePlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: N/A | License: Verified | Primary: Secondary |
1223P0300X — Dentist, PeriodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: N/A | License: Verified | Primary: Secondary |
1223S0112X — Dentist, Oral and Maxillofacial SurgeryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: N/A | License: Verified | Primary: Secondary |
1223X0400X — Dentist, Orthodontics and Dentofacial OrthopedicsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: N/A | License: Verified | Primary: Secondary |
124Q00000X — Dental HygienistPlain English: Licensed & Credentialed Dental Hygienist | State: N/A | License: Verified | Primary: Secondary |
126800000X — Dental AssistantPlain English: Licensed & Credentialed Dental Assistant | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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