GARLAND TOOTH FAIRY, PLLC
NPI: 1164157194
· FRISCO, TX 75035
· Dentist
· NPI assigned 07/22/2022
$518.43
Total Medicaid Paid
Provider Details
| Authorized Official | CHEN, YUEXI (DIRECTOR) |
| NPI Enumeration Date | 07/22/2022 |
Related Entities
Other providers sharing the same authorized official: CHEN, YUEXI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
50 |
$518.43 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
25 |
25 |
$251.20 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$149.63 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$117.60 |