NPI: 1417450404 · HIALEAH, FL 33015 · Dental Clinic/Center · NPI assigned 03/15/2018
| Authorized Official | GARCIA LOPEZ, DORGIS (PRESIDENT) |
| NPI Enumeration Date | 03/15/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 171 | $1K |
| 2021 | 159 | $2K |
| 2022 | 1,284 | $14K |
| 2023 | 1,024 | $11K |
| 2024 | 205 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0274 | Bitewings - four radiographic images | 369 | 342 | $18K |
| D1110 | Prophylaxis - adult | 667 | 628 | $12K |
| D0120 | Periodic oral evaluation - established patient | 765 | 714 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 395 | 372 | $40.90 |
| D1206 | Topical application of fluoride varnish | 50 | 49 | $29.95 |
| D1330 | 580 | 553 | $18.00 | |
| D1999 | 17 | 17 | $0.00 |