NORTH SHORE ORAL SURGERY, LLC
NPI: 1619249059
· SMITHTOWN, NY 11787
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 02/01/2012
$398K
Total Medicaid Paid
Provider Details
| Authorized Official | MONTAZEM, ALEX (DOCTOR/OWNER) |
| NPI Enumeration Date | 02/01/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
353 |
$20K |
| 2019 |
767 |
$48K |
| 2020 |
696 |
$43K |
| 2021 |
1,142 |
$106K |
| 2022 |
859 |
$94K |
| 2023 |
883 |
$59K |
| 2024 |
417 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
254 |
182 |
$103K |
| D9243 |
|
781 |
755 |
$97K |
| D9310 |
|
1,612 |
1,611 |
$97K |
| D0330 |
Panoramic radiographic image |
1,659 |
1,659 |
$51K |
| D9239 |
|
759 |
755 |
$42K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
52 |
50 |
$8K |