NPI: 1205011608 · TAYLORSVILLE, MS 39168 · Dentist · NPI assigned 01/03/2008
| Authorized Official | BRITT, JESSICA (CREDENTIALING COORDINATOR) |
| NPI Enumeration Date | 01/03/2008 |
Other providers sharing the same authorized official: BRITT, JESSICA
| Provider | City | State | Total Paid |
|---|---|---|---|
| MINNESOTA DENTAL PROFESSIONALS, P.C. | LAKEVILLE | MN | $10K |
| MINNESOTA DENTAL PROFESSIONALS, P.C. | BROOKLYN PARK | MN | $562.28 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,356 | $12K |
| 2019 | 249 | $2K |
| 2020 | 118 | $1K |
| 2021 | 1,062 | $13K |
| 2022 | 107 | $1K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 955 | 503 | $10K |
| D1206 | Topical application of fluoride varnish | 730 | 369 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 495 | 212 | $5K |
| D0120 | Periodic oral evaluation - established patient | 241 | 143 | $3K |
| D1351 | Sealant - per tooth | 204 | 26 | $2K |
| D0330 | Panoramic radiographic image | 76 | 41 | $776.85 |
| D0274 | Bitewings - four radiographic images | 58 | 36 | $770.56 |
| D0140 | Limited oral evaluation - problem focused | 31 | 13 | $520.85 |
| D1208 | Topical application of fluoride, excluding varnish | 44 | 29 | $365.01 |
| D0220 | Intraoral - periapical first radiographic image | 23 | 14 | $163.80 |
| D0272 | Bitewings - two radiographic images | 35 | 12 | $60.90 |