PARADISE DENTAL LLC
NPI: 1124503966
· INDIANAPOLIS, IN 46250
· Dental Clinic/Center
· NPI assigned 09/27/2018
$459.03
Total Medicaid Paid
Provider Details
| Authorized Official | VU, HUONG (OWNER/DENTIST) |
| NPI Enumeration Date | 09/27/2018 |
Related Entities
Other providers sharing the same authorized official: VU, HUONG
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
42 |
$459.03 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$243.68 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
12 |
$215.35 |