RESTORATION DENTAL GROUP LLC
NPI: 1093035081
· SHREVEPORT, LA 71105
· Dental Clinic/Center
· NPI assigned 06/02/2010
Provider Details
| Authorized Official | JARVIS, RAYMOND (OWNER OF RESTORATION DENTAL GROUP L) |
| NPI Enumeration Date | 06/02/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
42 |
$1K |
| 2023 |
63 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
68 |
68 |
$2K |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$576.12 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$385.22 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$257.01 |