SMILE ORTHODONTICS STILLWATER LLC
NPI: 1518572916
· SAINT PAUL, MN 55116
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 09/11/2020
$2.64M
Total Medicaid Paid
Provider Details
| Authorized Official | WOLFF, DOUGLAS (OWNER) |
| Parent Organization | SMILE ORTHODONTICS STILLWATER LLC |
| NPI Enumeration Date | 09/11/2020 |
Related Entities
Other providers sharing the same authorized official: WOLFF, DOUGLAS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
379 |
$52K |
| 2022 |
3,440 |
$566K |
| 2023 |
5,246 |
$903K |
| 2024 |
6,599 |
$1.11M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
4,485 |
4,480 |
$1.29M |
| D8670 |
Periodic orthodontic treatment visit |
3,378 |
3,377 |
$768K |
| D0340 |
|
1,432 |
1,429 |
$167K |
| D0350 |
|
1,683 |
1,678 |
$131K |
| D0330 |
Panoramic radiographic image |
1,628 |
1,622 |
$111K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,593 |
1,588 |
$91K |
| D0470 |
|
1,452 |
1,446 |
$68K |
| D8090 |
|
13 |
13 |
$10K |