BROADWAY MALL DENTAL
NPI: 1225183551
· HICKSVILLE, NY 11801
· Dentist
· NPI assigned 01/25/2007
Provider Details
| Authorized Official | LEVIN, IGOR (OWNER) |
| NPI Enumeration Date | 01/25/2007 |
Related Entities
Other providers sharing the same authorized official: LEVIN, IGOR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
196 |
$5K |
| 2023 |
1,326 |
$38K |
| 2024 |
1,271 |
$33K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
552 |
552 |
$26K |
| D0210 |
Intraoral - complete series of radiographic images |
600 |
600 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
469 |
469 |
$11K |
| D0230 |
Intraoral - periapical each additional radiographic image |
470 |
470 |
$10K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
114 |
61 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
501 |
501 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
50 |
50 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
25 |
25 |
$297.50 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$295.80 |