NPI: 1275759912 · SHERMAN OAKS, CA 91423 · Dental Clinic/Center · NPI assigned 04/18/2007
| Authorized Official | KVITKO, KIRILL (PRESIDENT) |
| NPI Enumeration Date | 04/18/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 294 | $8K |
| 2019 | 39 | $801.00 |
| 2020 | 26 | $634.00 |
| 2021 | 65 | $2K |
| 2023 | 150 | $4K |
| 2024 | 139 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 109 | 109 | $4K |
| D1110 | Prophylaxis - adult | 81 | 81 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 339 | 338 | $4K |
| D0120 | Periodic oral evaluation - established patient | 70 | 69 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 82 | 81 | $3K |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $259.20 |
| D0230 | Intraoral - periapical each additional radiographic image | 20 | 12 | $81.00 |