NPI: 1174038327 · FAIRFIELD, CT 06824 · General Practice Dentistry · NPI assigned 12/11/2017
| Authorized Official | NA, CHANG HYUN (OWNER) |
| NPI Enumeration Date | 12/11/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $399.36 |
| 2020 | 113 | $2K |
| 2021 | 304 | $6K |
| 2022 | 341 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 197 | 197 | $4K |
| D0274 | Bitewings - four radiographic images | 107 | 107 | $3K |
| D1110 | Prophylaxis - adult | 96 | 96 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 210 | 201 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 121 | 120 | $1K |
| D0120 | Periodic oral evaluation - established patient | 39 | 39 | $806.30 |