GLOBAL SMILES DENTAL 12 LLC
NPI: 1114757168
· MARTINSVILLE, IN 46151
· General Practice Dentistry
· NPI assigned 08/05/2024
$860.90
Total Medicaid Paid
Provider Details
| Authorized Official | WHITE, TIA (CREDENTIALING ASSOCIATE) |
| NPI Enumeration Date | 08/05/2024 |
Related Entities
Other providers sharing the same authorized official: WHITE, TIA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
24 |
$860.90 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$552.26 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$308.64 |