NPI: 1316224769 · ROWLETT, TX 75088 · General Practice Dentistry · NPI assigned 11/14/2011
| Authorized Official | MONTOYA, JOSE (PRESIDENT) |
| NPI Enumeration Date | 11/14/2011 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 63 | $2K |
| 2021 | 653 | $16K |
| 2022 | 712 | $15K |
| 2023 | 826 | $17K |
| 2024 | 494 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 677 | 644 | $34K |
| D0120 | Periodic oral evaluation - established patient | 367 | 348 | $10K |
| D1208 | Topical application of fluoride, excluding varnish | 605 | 577 | $8K |
| D0274 | Bitewings - four radiographic images | 115 | 107 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 224 | 107 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 148 | 139 | $2K |
| D0603 | 612 | 580 | $0.00 |