JACKSON DENTAL GROUP, LLC
NPI: 1184347452
· WEST CHESTER, OH 45069
· Pediatric Dentist
· NPI assigned 09/22/2022
Provider Details
| Authorized Official | JACKSON, KYLE (PRESIDENT) |
| NPI Enumeration Date | 09/22/2022 |
Related Entities
Other providers sharing the same authorized official: JACKSON, KYLE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
720 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
184 |
183 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
128 |
127 |
$6K |
| D1206 |
Topical application of fluoride varnish |
192 |
191 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
83 |
82 |
$4K |
| D0272 |
Bitewings - two radiographic images |
102 |
101 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
12 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$503.40 |