LITTLE SMILES DENTALOFFICE #4
NPI: 1073874723
· LAKE WORTH, FL 33460
· Dental Clinic/Center
· NPI assigned 05/30/2012
Provider Details
| Authorized Official | CORTES, GONZALO (OWNER) |
| Parent Organization | LITTLE SMILES DENTAL #1 |
| NPI Enumeration Date | 05/30/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,754 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
240 |
240 |
$23K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
29 |
29 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
130 |
129 |
$548.50 |
| D1351 |
Sealant - per tooth |
77 |
16 |
$285.36 |
| D1330 |
|
289 |
289 |
$63.94 |
| D1120 |
Prophylaxis - child |
236 |
236 |
$46.08 |
| D1110 |
Prophylaxis - adult |
29 |
29 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
213 |
213 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
442 |
112 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
69 |
69 |
$0.00 |