EVOLVE DENTAL MEDSPA
NPI: 1164261822
· SMYRNA, TN 37167
· Dentist
· NPI assigned 05/22/2024
Provider Details
| Authorized Official | LANVIN, ALEXA (OFFICE MANAGER) |
| Parent Organization | CRYSTAL CLEAR FAMILY DENTISTRY |
| NPI Enumeration Date | 05/22/2024 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
545 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1354 |
|
473 |
31 |
$2K |
| D1110 |
Prophylaxis - adult |
29 |
29 |
$1K |
| D1206 |
Topical application of fluoride varnish |
31 |
31 |
$556.20 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$214.97 |