RESERVOIR SMILES DENTISTRY, PLLC
NPI: 1316458136
· BRANDON, MS 39047
· Dental Clinic/Center
· NPI assigned 10/19/2017
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | SHAMBURGER, AMYE (OWNER) |
| Parent Organization | HALL FAMILY DENTISTRY |
| NPI Enumeration Date | 10/19/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
39 |
$0.00 |
| 2022 |
25 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
31 |
26 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
33 |
27 |
$0.00 |