HKDDS SMILE, PLLC
NPI: 1578947123
· AUSTIN, TX 78750
· General Practice Dentistry
· NPI assigned 07/14/2015
$375.05
Total Medicaid Paid
Provider Details
| Authorized Official | KIM, TORI (OFFICE MANAGER) |
| NPI Enumeration Date | 07/14/2015 |
Related Entities
Other providers sharing the same authorized official: KIM, TORI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
27 |
$375.05 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
13 |
$375.05 |
| D0601 |
|
13 |
13 |
$0.00 |