ISMILE ORTHODONTICS OF WATERBURY LLC
NPI: 1326720194
· WATERBURY, CT 06705
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 08/02/2023
$315K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: GIANNOUTSOS, EFSTATHIOS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
39 |
$0.00 |
| 2023 |
757 |
$83K |
| 2024 |
3,302 |
$232K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
3,376 |
3,148 |
$271K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
41 |
40 |
$24K |
| D8660 |
|
638 |
544 |
$18K |
| D0330 |
Panoramic radiographic image |
29 |
29 |
$2K |
| D0470 |
|
14 |
14 |
$1K |