CANTON VALLEY DENTAL LLC
NPI: 1154560118
· CANTON, CT 06019
· General Practice Dentistry
· NPI assigned 02/16/2009
Provider Details
| Authorized Official | KEEFE, MATTHEW (DENTIST/PARTNER) |
| NPI Enumeration Date | 02/16/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
315 |
$8K |
| 2019 |
333 |
$10K |
| 2020 |
247 |
$7K |
| 2021 |
115 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
591 |
561 |
$14K |
| D1120 |
Prophylaxis - child |
260 |
255 |
$10K |
| D1206 |
Topical application of fluoride varnish |
87 |
86 |
$2K |
| D1110 |
Prophylaxis - adult |
45 |
44 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
12 |
$390.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$341.04 |