DENTAL FAMILY PRACTICE
NPI: 1558483305
· LAKE RIDGE, VA 22192
· Periodontist
· NPI assigned 04/04/2007
Provider Details
| Authorized Official | MOSTOFI, MINA (DENTIST) |
| NPI Enumeration Date | 04/04/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
143 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
77 |
77 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
42 |
42 |
$846.30 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$566.28 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$402.24 |