NPI: 1669950630 · VALENCIA, CA 91355 · Dental Clinic/Center · NPI assigned 08/01/2018
| Authorized Official | UMUTANGANA, GLORIA (PERSONAL ASSISTANT) |
| NPI Enumeration Date | 08/01/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 65 | $995.80 |
| 2019 | 672 | $12K |
| 2020 | 1,096 | $13K |
| 2021 | 1,426 | $15K |
| 2022 | 989 | $13K |
| 2023 | 32 | $960.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9430 | 648 | 511 | $18K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 232 | 227 | $12K |
| D0230 | Intraoral - periapical each additional radiographic image | 2,619 | 561 | $9K |
| D0120 | Periodic oral evaluation - established patient | 148 | 144 | $6K |
| D0274 | Bitewings - four radiographic images | 249 | 247 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 179 | 175 | $2K |
| D1120 | Prophylaxis - child | 71 | 67 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 46 | 46 | $1K |
| D1999 | 88 | 68 | $75.00 |