S. SHAUN DANESHGAR DMD INC
NPI: 1215605845
· LOS ANGELES, CA 90033
· Dental Clinic/Center
· NPI assigned 08/30/2021
$192K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: DANESHGAR, MICHAEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
324 |
$14K |
| 2023 |
1,158 |
$54K |
| 2024 |
2,759 |
$124K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
710 |
705 |
$47K |
| D0210 |
Intraoral - complete series of radiographic images |
506 |
505 |
$24K |
| D9430 |
|
724 |
635 |
$23K |
| D1110 |
Prophylaxis - adult |
268 |
267 |
$22K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
254 |
143 |
$17K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
35 |
24 |
$17K |
| D1320 |
|
794 |
787 |
$13K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
167 |
76 |
$9K |
| D1206 |
Topical application of fluoride varnish |
465 |
465 |
$8K |
| D4341 |
|
78 |
20 |
$5K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
36 |
12 |
$4K |
| D0350 |
|
156 |
61 |
$2K |
| D4910 |
|
16 |
16 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
32 |
12 |
$129.60 |