PIONEER SMILES PLLC

NPI: 1164960761 · IRVING, TX 75061 · General Practice Dentistry · NPI assigned 02/03/2017

$9K

Total Medicaid Paid

260

Total Claims

185

Beneficiaries

Codes Billed

2018-02

First Month

2019-05

Last Month

Provider Details

Authorized Official	IQBAL, SYED (OWNER DENTIST)
NPI Enumeration Date	02/03/2017

Other providers sharing the same authorized official: IQBAL, SYED

Provider	City	State	Total Paid
MINTY SMILES	DUNCANVILLE	TX	$69K
WYLIE SMILES PLLC	WYLIE	TX	$25K
SMILES SO WHITE PLLC	GARLAND	TX	$11K
SANGER DENTAL PLLC	SANGER	TX	$10K
BUDGET SMILES PLLC	GUN BARREL CITY	TX	$6K
GENESEE VALLEY CARDIOLOGY PLLC	DANSVILLE	NY	$5K

Year	Claims	Total Paid
2018	248	$9K
2019	12	$0.00

Code	Description	Claims	Beneficiaries	Total Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	62	13	$6K
D0150	Comprehensive oral evaluation - new or established patient	26	26	$918.32
D0230	Intraoral - periapical each additional radiographic image	40	14	$460.40
D1120	Prophylaxis - child	12	12	$441.00
D1208	Topical application of fluoride, excluding varnish	26	26	$382.20
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	12	12	$333.72
D0220	Intraoral - periapical first radiographic image	14	14	$175.84
D0603		68	68	$0.00