Dental-Provider Specialty Taxonomy Codes

October 6th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Categories:   Coding   Claims   Dental  
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The National Uniform Billing Guidelines require the use of taxonomy codes for claims submissions on the ADA-Dental claim form and the CMS-1500 Medical Claim form. When reporting the taxonomy code, be sure the provider is contracted with the payer under the taxonomy code being reported. We have listed the general sub-set of taxonomy codes suggested by the ADA, however, the ADA also states, "The general code listed as 'Dentist' may be used instead of any of the other codes." 

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.) licensed by the state to practice dentistry, and practicing within the scope of that license. 

Provider Taxonomy      Code

Dentist

122300000X
General Practice 1223G0001X
Dental Public Health 1223D0001X
Endodontics 1223E0200X
Orthodontics 1223X0400X
Pediatric Dentistry 1223P0221X
Periodontics 1223P0300X
Prosthodontics 1223P0700X
Oral & Maxillofacial Pathology 1223P0106X
Oral & Maxillofacial Radiology 1223D0008X
Oral & Maxillofacial Surgery 1223S0112X

For a complete list of provider taxonomy codes click here.

Taxonomy codes should be submitted on claim forms as follows:

ADA 2019 claim form 

• Box 56a should contain the taxonomy code 

CMS-1500 claim form

Rendering Provider

     • Box 24i should contain the qualifier ZZ
     • Box 24j should contain the taxonomy code 

Billing Provider

     • Box 33b should contain the qualifier along with the taxonomy code

Referring Provider

     • If a referring provider is indicated in box 17 on the claim, then Box 17a should contain the qualifier of ZZ along with the taxonomy code in the next column.

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