BUBBLE GUM KIDS DENTISTRY CLINTON TWP
NPI: 1558149195
· CLINTON TOWNSHIP, MI 48038
· Pediatric Dentist
· NPI assigned 09/15/2023
$164K
Total Medicaid Paid
Provider Details
| Authorized Official | PAUNDLAY, AMY (SR. VP OF POSITION) |
| NPI Enumeration Date | 09/15/2023 |
Related Entities
Other providers sharing the same authorized official: PAUNDLAY, AMY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
3,175 |
$164K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
Prefabricated stainless steel crown - primary tooth |
205 |
91 |
$42K |
| D7140 |
Extraction, erupted tooth or exposed root |
231 |
131 |
$25K |
| D1120 |
Prophylaxis - child |
523 |
523 |
$24K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
371 |
371 |
$23K |
| D1206 |
Topical application of fluoride varnish |
473 |
473 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
128 |
126 |
$9K |
| D0240 |
|
277 |
149 |
$7K |
| D0272 |
Bitewings - two radiographic images |
248 |
248 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
274 |
273 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
313 |
237 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
75 |
75 |
$3K |
| D0145 |
Oral evaluation for a patient under three years of age |
57 |
57 |
$2K |