NPI: 1336487750 · SUNNYSIDE, NY 11104 · Orthodontics and Dentofacial Orthopedic Dentist · NPI assigned 01/18/2013
| Authorized Official | LEE, JASMINE (MANAGER) |
| NPI Enumeration Date | 01/18/2013 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,274 | $246K |
| 2019 | 1,515 | $176K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D8670 | Periodic orthodontic treatment visit | 1,454 | 1,454 | $343K |
| D8660 | 664 | 664 | $19K | |
| D0340 | 501 | 501 | $18K | |
| D0330 | Panoramic radiographic image | 528 | 528 | $16K |
| D8080 | Comprehensive orthodontic treatment of the adolescent dentition | 13 | 13 | $13K |
| D8680 | 40 | 40 | $7K | |
| D0350 | 589 | 589 | $6K |