LEDENTAL LLC
NPI: 1104360718
· SANDY, OR 97055
· General Practice Dentistry
· NPI assigned 12/16/2016
Provider Details
| Authorized Official | LE, TIN (OWNER) |
| NPI Enumeration Date | 12/16/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
27 |
$599.00 |
| 2019 |
26 |
$575.00 |
| 2020 |
90 |
$2K |
| 2021 |
63 |
$611.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
71 |
71 |
$2K |
| D1206 |
Topical application of fluoride varnish |
51 |
51 |
$871.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$468.00 |
| D1999 |
|
72 |
65 |
$105.00 |