NPI: 1447311451 · MONTGOMERY, WV 25136 · General Practice Dentistry · NPI assigned 12/13/2006
| Authorized Official | DILLON, KIMBERLY (ACCOUNT MANAGER) |
| NPI Enumeration Date | 12/13/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 26 | $755.00 |
| 2020 | 16 | $0.00 |
| 2024 | 462 | $18K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 190 | 167 | $7K |
| D1110 | Prophylaxis - adult | 59 | 59 | $3K |
| D0120 | Periodic oral evaluation - established patient | 126 | 126 | $3K |
| D0330 | Panoramic radiographic image | 41 | 41 | $3K |
| D1206 | Topical application of fluoride varnish | 45 | 45 | $924.00 |
| D1120 | Prophylaxis - child | 14 | 14 | $440.00 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $214.50 |
| D1999 | 16 | 12 | $0.00 |