NPI: 1548431018 · SAN PEDRO, CA 90731 · General Practice Dentistry · NPI assigned 03/12/2008
| Authorized Official | RUBIANO, GUILLERMO (DENTIST/PRESIDENT) |
| NPI Enumeration Date | 03/12/2008 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 36 | $987.00 |
| 2024 | 299 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 58 | 58 | $4K |
| D1110 | Prophylaxis - adult | 40 | 40 | $4K |
| D0210 | Intraoral - complete series of radiographic images | 32 | 32 | $2K |
| D1320 | 60 | 59 | $927.50 | |
| D1208 | Topical application of fluoride, excluding varnish | 57 | 57 | $840.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 64 | 38 | $238.95 |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $144.00 |
| D0431 | 12 | 12 | $0.00 |