GRUPO DENTAL CDT DR. LOPEZ ANTONGIORGI
NPI: 1255601332
· SAN JUAN, PR 00920
· Dental Clinic/Center
· NPI assigned 01/06/2012
Provider Details
| Authorized Official | VEGA DE JESUS, MARITZA (EXECUTIVE SUB DIRECTOR) |
| Parent Organization | CDT DR. LOPEZ ANTONGIORGI |
| NPI Enumeration Date | 01/06/2012 |
Related Entities
Other providers sharing the same authorized official: VEGA DE JESUS, MARITZA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
53 |
$848.60 |
| 2023 |
1,097 |
$22K |
| 2024 |
714 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
349 |
233 |
$12K |
| D1999 |
|
639 |
460 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
218 |
159 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
280 |
182 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
220 |
148 |
$3K |
| D1120 |
Prophylaxis - child |
133 |
86 |
$3K |
| D2140 |
|
25 |
20 |
$991.75 |