KDNASHVILLEDC
NPI: 1629767793
· HERMITAGE, TN 37076
· General Practice Dentistry
· NPI assigned 05/04/2023
Provider Details
| Authorized Official | WAN, TANYIKA (VP ADMINISTRATIVE SERVICES) |
| NPI Enumeration Date | 05/04/2023 |
Related Entities
Other providers sharing the same authorized official: WAN, TANYIKA
| Provider | City | State | Total Paid |
|---|
| KDPCTN |
HERMITAGE |
TN |
$1.40M |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
2,384 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
139 |
92 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
124 |
82 |
$3K |
| D1206 |
Topical application of fluoride varnish |
212 |
134 |
$2K |
| D0274 |
Bitewings - four radiographic images |
40 |
29 |
$607.24 |
| D0330 |
Panoramic radiographic image |
39 |
28 |
$548.00 |
| D9920 |
|
398 |
90 |
$515.58 |
| D0230 |
Intraoral - periapical each additional radiographic image |
60 |
12 |
$220.85 |
| D0220 |
Intraoral - periapical first radiographic image |
24 |
14 |
$153.72 |
| D0350 |
|
42 |
27 |
$10.04 |
| D1330 |
|
220 |
138 |
$0.00 |
| D9997 |
|
731 |
391 |
$0.00 |
| D0603 |
|
82 |
53 |
$0.00 |
| D9991 |
|
273 |
172 |
$0.00 |