MONA LISA SMILES PLLC
NPI: 1447758701
· BEE CAVE, TX 78738
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 01/31/2018
Provider Details
| Authorized Official | REZAPOUR, MONA (DOCTOR/OWNER) |
| NPI Enumeration Date | 01/31/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
193 |
$2K |
| 2022 |
72 |
$349.86 |
| 2023 |
76 |
$989.33 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
47 |
42 |
$1K |
| D1206 |
Topical application of fluoride varnish |
88 |
82 |
$1K |
| D1120 |
Prophylaxis - child |
27 |
27 |
$988.58 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$327.32 |
| D0603 |
|
165 |
135 |
$0.00 |