1101 DENTAL, PLLC — NPI 1750689030 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in GRAND FORKS, ND)

Plain-English Taxonomy Translation (122300000X)

What Does Taxonomy Code 122300000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 122300000X translates in plain language to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

Primary Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
When Patients Should Consult: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

CMS Medicare Utilization & Part D Prescribing Benchmarks

Common Procedures & Clinical Prescribing Profile

Typical clinical procedures (Medicare Part B Utilization) and therapeutic classes (Medicare Part D Prescribing) associated with 1101 DENTAL, PLLC:

High-Volume Clinical Procedures & Diagnostics:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic & Prescribing Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	1750689030 (NPI-2 Organization / Facility)
Provider / Legal Name	1101 DENTAL, PLLC
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	1101 S COLUMBIA RD, UNIT B, GRAND FORKS, ND, 582014055
Practice Telephone / Fax	Tel: 701-795-1101 \| Fax: 701-795-1102
Administrative Mailing Address	1101 S COLUMBIA RD, GRAND FORKS, ND, 582014055
Enumeration & Last Sync	Enumerated: 2011-03-10 \| Updated: 2011-03-10
Authorized Official	HEATHER PETRICIG (owner/dentist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1101 S COLUMBIA RD, UNIT B, GRAND FORKS, ND, 582014055

🗺️ Open in Google Maps & Parking ⚙️ View Enriched JSON API

ADA & HIPAA Verification Note: Practice locations registered as primary LOCATION addresses under CMS NPPES are clinical service delivery sites (distinct from billing/mailing addresses).

🔒 Are you 1101 DENTAL, PLLC? Redact or update your phone/address in 1 click →

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: ND \| License: 2083 \| Primary Taxonomy: Yes

1101 DENTAL, PLLC (NPI #1750689030)