JACKSON DENTAL ALLIANCE, PLLC
NPI: 1396431060
· MT JULIET, TN 37122
· Dental Clinic/Center
· NPI assigned 04/14/2023
Provider Details
| Authorized Official | JACKSON, RONALD (PRESIDENT/CEO) |
| NPI Enumeration Date | 04/14/2023 |
Related Entities
Other providers sharing the same authorized official: JACKSON, RONALD
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
160 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
47 |
47 |
$1K |
| D1206 |
Topical application of fluoride varnish |
44 |
44 |
$881.50 |
| D0330 |
Panoramic radiographic image |
17 |
17 |
$602.95 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
19 |
19 |
$579.37 |
| D0272 |
Bitewings - two radiographic images |
33 |
32 |
$493.35 |