CMS-1500 Box 24J / 33a • NPI
1891865861
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
1223E0200X
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
5175 E PACIFIC COAST HWY STE 405, LONG BEACH, CA, 90804-3313
✓ 9-Digit EDI 837 ZIP+4 (90804-3313)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1891865861 (HAMID REZA ABEDI) 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 | 1891865861 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | HAMID REZA ABEDI |
| 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 | 5175 E PACIFIC COAST HWY STE 405, LONG BEACH, CA, 90804-3313 |
| Practice Telephone / Fax | Tel: (562) 597-8864 | Fax: (562) 597-8402 |
| Administrative Mailing Address | 3141 MICHELSON DR UNIT 1803, IRVINE, CA, 92612-5675 |
| Enumeration & Last Sync | Enumerated: 2006-11-08 | CMS Record Updated: 2026-06-18 |
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 (HAMID REZA ABEDI)
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: NV | License: S7-129C | Primary: Secondary |
1223E0200X — Dentist, EndodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: CA | License: 43300 | Primary: Yes (Primary) |
261QD0000X — Clinic/Center, DentalPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: MN | License: S179 | Primary: Secondary |
1223E0200X — Dentist, EndodonticsPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: TX | License: 31474 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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