NPI: 1598757361 · CLARKSVILLE, TN 37042 · Pediatric Dentist · NPI assigned 08/18/2005
| Authorized Official | DEEDS, LARY (PRESIDENT OF CORPORATION) |
| NPI Enumeration Date | 08/18/2005 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 865 | $20K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 210 | 210 | $7K |
| D0120 | Periodic oral evaluation - established patient | 247 | 247 | $6K |
| D1206 | Topical application of fluoride varnish | 271 | 271 | $5K |
| D0272 | Bitewings - two radiographic images | 104 | 104 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 33 | 25 | $329.68 |