THE MAIN STREET DENTAL DEPOT, PLLC
NPI: 1609238393
· THE COLONY, TX 75056
· General Practice Dentistry
· NPI assigned 03/22/2016
Provider Details
| Authorized Official | KANA, HIMESH (MANAGING MEMBER) |
| NPI Enumeration Date | 03/22/2016 |
Related Entities
Other providers sharing the same authorized official: KANA, HIMESH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
108 |
$2K |
| 2021 |
1,505 |
$21K |
| 2022 |
2,138 |
$33K |
| 2023 |
1,664 |
$23K |
| 2024 |
1,096 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
726 |
666 |
$18K |
| D1120 |
Prophylaxis - child |
528 |
494 |
$16K |
| D1206 |
Topical application of fluoride varnish |
1,109 |
1,038 |
$14K |
| D0274 |
Bitewings - four radiographic images |
423 |
382 |
$10K |
| D1110 |
Prophylaxis - adult |
197 |
186 |
$9K |
| D1351 |
Sealant - per tooth |
408 |
71 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
665 |
617 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
659 |
546 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
39 |
16 |
$2K |
| D0330 |
Panoramic radiographic image |
129 |
125 |
$2K |
| D0272 |
Bitewings - two radiographic images |
113 |
106 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
24 |
24 |
$741.72 |
| D0240 |
|
54 |
27 |
$490.00 |
| D0350 |
|
25 |
25 |
$165.42 |
| D1999 |
|
158 |
129 |
$0.00 |
| D0603 |
|
1,254 |
1,175 |
$0.00 |