FIELAT SANDU DENTAL PRACTICE

NPI: 1609657725 · MISSION VIEJO, CA 92692 · Pediatric Dentist · NPI assigned 10/13/2023

$9K

Total Medicaid Paid

401

Total Claims

247

Beneficiaries

Codes Billed

2024-07

First Month

2024-11

Last Month

Provider Details

Authorized Official	ABUL-FIELAT, MOHAMMAD (DENTIST/OWNER)
Parent Organization	FIELAT SANDU DENTAL PRACTICE
NPI Enumeration Date	10/13/2023

Other providers sharing the same authorized official: ABUL-FIELAT, MOHAMMAD

Provider	City	State	Total Paid
MOHAMMAD ABUL-FIELAT DDS INC	CHINO	CA	$8.30M
MOHAMMAD ABUL FIELAT DDS INC	MORENO VALLEY	CA	$6.44M
MOHAMMAD ABUL FIELAT DDS INC	FONTANA	CA	$4.88M
MOHAMMAD ABUL-FIELAT DDS INC	SANTA ANA	CA	$3.69M
MOHAMMAD ABUL FIELAT DDS INC	EASTVALE	CA	$811K
MOHAMMAD ABUL FIELAT DDS INC	ANAHEIM	CA	$796K
MOHAMMAD ABUL-FIELAT DDS INC	RIVERSIDE	CA	$233K
MOHAMMAD ABUL FIELAT DDS INC	IRVINE	CA	$154K
MOHAMMAD ABUL-FIELAT DDS INC	GARDEN GROVE	CA	$4K

Year	Claims	Total Paid
2024	401	$9K

Code	Description	Claims	Beneficiaries	Total Paid
D0150	Comprehensive oral evaluation - new or established patient	46	46	$3K
D1120	Prophylaxis - child	52	52	$3K
D0230	Intraoral - periapical each additional radiographic image	194	61	$1K
D1208	Topical application of fluoride, excluding varnish	36	36	$679.00
D0140	Limited oral evaluation - problem focused	12	12	$420.00
D0330	Panoramic radiographic image	12	12	$360.00
D0350		33	12	$316.80
D0272	Bitewings - two radiographic images	16	16	$192.00