NPI: 1316315724 · PANORAMA CITY, CA 91402 · Dental Clinic/Center · NPI assigned 09/02/2015
| Authorized Official | NIKJOO, EDI (CEO) |
| NPI Enumeration Date | 09/02/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 12 | $726.00 |
| 2022 | 213 | $12K |
| 2023 | 109 | $6K |
| 2024 | 226 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 204 | 203 | $13K |
| D0210 | Intraoral - complete series of radiographic images | 106 | 105 | $5K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 55 | 15 | $4K |
| D9430 | 113 | 102 | $3K | |
| D1120 | Prophylaxis - child | 14 | 14 | $735.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 54 | 13 | $204.56 |
| D1208 | Topical application of fluoride, excluding varnish | 14 | 14 | $191.00 |