NPI: 1134520943 · SAN JOSE, CA 95148 · Preferred Provider Organization · NPI assigned 09/11/2014
| Authorized Official | LE, LUAN (DENTIST/PRESIDENT) |
| NPI Enumeration Date | 09/11/2014 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 25 | $483.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 25 | 25 | $483.00 |