SMILES INC P C
NPI: 1548603475
· TYLERTOWN, MS 39667
· General Practice Dentistry
· NPI assigned 04/10/2013
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | WOODS, JACKIE (PRESIDENT) |
| NPI Enumeration Date | 04/10/2013 |
Related Entities
Other providers sharing the same authorized official: WOODS, JACKIE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
572 |
$0.00 |
| 2019 |
203 |
$0.00 |
| 2020 |
41 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
104 |
29 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
220 |
58 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
28 |
14 |
$0.00 |
| D1120 |
Prophylaxis - child |
415 |
132 |
$0.00 |
| D0330 |
Panoramic radiographic image |
49 |
12 |
$0.00 |