ELGENDI DENTAL CORPORATION
NPI: 1326612607
· LA PUENTE, CA 91744
· Dental Clinic/Center
· NPI assigned 05/19/2021
Provider Details
| Authorized Official | GOMEZ, LUPE (OFFICE MANAGER) |
| NPI Enumeration Date | 05/19/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
61 |
$3K |
| 2023 |
70 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
51 |
51 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
36 |
36 |
$2K |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$170.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$150.50 |
| D1320 |
|
17 |
17 |
$110.00 |