FAMILY DENTAL HEALTH OF CLEVELAND STREET, LLC
NPI: 1619325107
· GREENVILLE, SC 29607
· General Practice Dentistry
· NPI assigned 05/25/2016
Provider Details
| Authorized Official | SAFRIT, BOBBY (OWNER) |
| Parent Organization | FDH HOLDINGS |
| NPI Enumeration Date | 05/25/2016 |
Related Entities
Other providers sharing the same authorized official: SAFRIT, BOBBY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
198 |
$7K |
| 2021 |
115 |
$4K |
| 2022 |
273 |
$9K |
| 2023 |
172 |
$4K |
| 2024 |
24 |
$537.80 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
146 |
146 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
151 |
151 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
165 |
165 |
$4K |
| D1206 |
Topical application of fluoride varnish |
170 |
170 |
$3K |
| D1120 |
Prophylaxis - child |
48 |
48 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
21 |
13 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
26 |
26 |
$946.60 |
| D0220 |
Intraoral - periapical first radiographic image |
43 |
43 |
$542.04 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$330.12 |