SEA OF SMILES 4 LLC
NPI: 1598309106
· JENKINTOWN, PA 19046
· Pediatric Dentist
· NPI assigned 11/06/2019
Provider Details
| Authorized Official | PATEL, RAJ (OWNER) |
| NPI Enumeration Date | 11/06/2019 |
Related Entities
Other providers sharing the same authorized official: PATEL, RAJ
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
1,610 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
257 |
256 |
$7K |
| D1206 |
Topical application of fluoride varnish |
258 |
257 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
195 |
195 |
$4K |
| D0603 |
|
252 |
251 |
$2K |
| D1330 |
|
258 |
257 |
$1K |
| D0272 |
Bitewings - two radiographic images |
55 |
55 |
$1K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
15 |
12 |
$510.88 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
18 |
18 |
$427.08 |
| D0220 |
Intraoral - periapical first radiographic image |
30 |
30 |
$293.77 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$124.93 |
| D1310 |
|
259 |
258 |
$0.00 |