SJ SUMMIT DENTAL INC
NPI: 1447497177
· ARTESIA, CA 90701
· Dental Clinic/Center
· NPI assigned 01/16/2009
Provider Details
| Authorized Official | BELEN, MARIA (DENTIST) |
| NPI Enumeration Date | 01/16/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
88 |
$0.00 |
| 2019 |
209 |
$0.00 |
| 2020 |
27 |
$0.00 |
| 2021 |
155 |
$0.00 |
| 2022 |
172 |
$0.00 |
| 2023 |
207 |
$5K |
| 2024 |
63 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
314 |
309 |
$6K |
| D1110 |
Prophylaxis - adult |
305 |
292 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
121 |
119 |
$553.00 |
| D0330 |
Panoramic radiographic image |
112 |
112 |
$450.28 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
27 |
$0.00 |
| D1120 |
Prophylaxis - child |
27 |
26 |
$0.00 |