NPI: 1134856768 · DETROIT, MI 48226 · Dental Clinic/Center · NPI assigned 08/03/2022
| Authorized Official | HENDERSON, ELBERT (DENTIST) |
| NPI Enumeration Date | 08/03/2022 |
Other providers sharing the same authorized official: HENDERSON, ELBERT
| Provider | City | State | Total Paid |
|---|---|---|---|
| HENDERSON & ASSOCIATES DDS PC DBA JOLLY SMILES MOBILE DENTAL SERVICES | DETROIT | MI | $317K |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 15 | $848.00 |
| 2024 | 12 | $698.78 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 27 | 27 | $2K |