Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › PASADENA › PHANTASTIC FAMILY DENTAL CENTER

PHANTASTIC FAMILY DENTAL CENTER

NPI: 1174800486 · PASADENA, TX 77506 · General Practice Dentistry · NPI assigned 11/15/2011

$844.90
Total Medicaid Paid
105
Total Claims
75
Beneficiaries
4
Codes Billed
2022-05
First Month
2022-10
Last Month

Provider Details

Authorized OfficialPHAN, MINH (PRESIDENT)
NPI Enumeration Date11/15/2011

Related Entities

Other providers sharing the same authorized official: PHAN, MINH

ProviderCityStateTotal Paid
NEW ESSENCE HEALTH CARE INC. HOUSTON TX $12.35M
PHANTASTIC SMILES PA PASADENA TX $766K
MINH PHAN DDS PA PASADENA TX $174K
PHANTASTIC FAMILY DENTAL CARE PA HOUSTON TX $140K
PHANTASTIC DENTAL CARE PA GALENA PARK TX $34K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 105 $844.90

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 14 14 $403.90
D0240 43 15 $235.20
D1208 Topical application of fluoride, excluding varnish 15 15 $205.80
D0601 33 31 $0.00