PEDIATRIC DENTISTRY
NPI: 1124892344
· LEONARDTOWN, MD 20650
· Pediatric Dentist
· NPI assigned 11/08/2023
Provider Details
| Authorized Official | JUAMBELTZ, JOSE (OWNER) |
| NPI Enumeration Date | 11/08/2023 |
Related Entities
Other providers sharing the same authorized official: JUAMBELTZ, JOSE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
110 |
$0.00 |
| 2024 |
2,040 |
$72K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
432 |
432 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
535 |
535 |
$16K |
| D1206 |
Topical application of fluoride varnish |
584 |
584 |
$14K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
51 |
39 |
$7K |
| D1110 |
Prophylaxis - adult |
73 |
73 |
$5K |
| D1351 |
Sealant - per tooth |
99 |
49 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
186 |
163 |
$4K |
| D0272 |
Bitewings - two radiographic images |
177 |
177 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$153.66 |