SMILE ZONE DENTISTRY, PORT JERVIS PC
NPI: 1164861266
· PORT JERVIS, NY 12771
· General Practice Dentistry
· NPI assigned 06/21/2013
Provider Details
| Authorized Official | BAJAJ, SAMIR (DIRECTOR) |
| NPI Enumeration Date | 06/21/2013 |
Related Entities
Other providers sharing the same authorized official: BAJAJ, SAMIR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
90 |
$0.00 |
| 2021 |
249 |
$2K |
| 2022 |
55 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
43 |
43 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
20 |
20 |
$600.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$516.00 |
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$408.90 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$308.32 |
| D1999 |
|
291 |
238 |
$0.00 |