JUST SMILES DENTAL
NPI: 1184798522
· MANSFIELD, TX 76063
· General Practice Dentistry
· NPI assigned 11/18/2006
$839.20
Total Medicaid Paid
Provider Details
| Authorized Official | DO, TIMOTHY (PRESIDENT) |
| NPI Enumeration Date | 11/18/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
27 |
$185.22 |
| 2022 |
25 |
$479.05 |
| 2023 |
24 |
$174.93 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
38 |
38 |
$521.85 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$317.35 |
| D0602 |
|
26 |
26 |
$0.00 |