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GREAT LAKES FAMILY DENTAL GROUP-LIVONIA, P.C.
GREAT LAKES FAMILY DENTAL GROUP-LIVONIA, P.C.
NPI: 1497077630
· LIVONIA, MI 48154
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 02/15/2010
Provider Details
| Authorized Official | GRAY, C (OWNER/PRESIDENT) |
| NPI Enumeration Date | 02/15/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
25 |
$661.00 |
| 2020 |
73 |
$2K |
| 2021 |
55 |
$1K |
| 2022 |
39 |
$899.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
129 |
129 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
51 |
51 |
$1K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$451.00 |