NPI: 1033370341 · ALMONT, MI 48003 · General Practice Dentistry · NPI assigned 06/19/2008
| Authorized Official | HART, PATRICIA (CORPORATE MANAGER) |
| NPI Enumeration Date | 06/19/2008 |
Other providers sharing the same authorized official: HART, PATRICIA
| Provider | City | State | Total Paid |
|---|---|---|---|
| GREAT LAKES FAMILY DENTAL GROUP SAGINAW, PC | SAGINAW | MI | $436K |
| GREAT LAKES FAMILY DENTAL GROUP-MUNCIE, P.C. | MUNCIE | IN | $429K |
| C PATRICK GRAY DDS PC | FLINT | MI | $310K |
| GREAT LAKES FAMILY DENTAL GROUP BLISSFIELD PC | BLISSFIELD | MI | $142K |
| GREAT LAKES FAMILY DENTAL GROUP - TECUMSEH PC | TECUMSEH | MI | $102K |
| GREAT LAKES FAMILY DENTAL GROUP-WARREN, P.C. | WARREN | MI | $30K |
| GREAT LAKES FAMILY DENTAL GROUP - MT MORRIS PC | MT MORRIS | MI | $15K |
| GREAT LAKES FAMILY DENTAL GROUP-ST. JOSEPH | SAINT JOSEPH | MI | $3K |
| GREAT LAKES FAMILY DENTALGROUP-HOWELL | HOWELL | MI | $3K |
| GREAT LAKES FAMILY DENTAL GROUP-DEWITT, P.C. | DEWITT | MI | $3K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 288 | $9K |
| 2019 | 264 | $8K |
| 2020 | 417 | $21K |
| 2021 | 606 | $17K |
| 2022 | 475 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 579 | 575 | $21K |
| D0120 | Periodic oral evaluation - established patient | 674 | 670 | $18K |
| D1208 | Topical application of fluoride, excluding varnish | 529 | 528 | $11K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 72 | 45 | $8K |
| D1110 | Prophylaxis - adult | 80 | 80 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 41 | 30 | $4K |
| D1206 | Topical application of fluoride varnish | 36 | 36 | $688.44 |
| D0274 | Bitewings - four radiographic images | 26 | 26 | $630.00 |
| D0272 | Bitewings - two radiographic images | 13 | 13 | $240.00 |