Dental Claim Form - Provider Specialty Code
This is the code that is to be entered in box 56A of the dental claim form.
Dentist | 122300000X |
General Practice | 1223G0001X |
Dental Public Health | 1223D0001X |
Endodontics | 1223E0200X |
Orthodontics | 1223X0400X |
Pediatric Dentistry | 1223P0221X |
Periodontics | 1223P0300X |
Prosthodontics | 1223P0700X |
Oral and Maxillofacial Pathology | 1223P0106X |
Oral and Maxillofacial Radiology | 1223D0008X |
Oral and Maxillofacial Surgery | 1223S0112X |
The 122300000X code for "Dentist" may be used by any licensed dentist ("A dentist is a person qualified by a doctorate in dental surgery or dental medicine licensed by the state to practice dentistry, and practicing within the scope of that license").
The other codes may be used instead if the dentist wants to further specify the area of practice.