NPI: 1689982050 · EL MONTE, CA 91731 · Dentist · NPI assigned 09/20/2010
| Authorized Official | FAJARDO, JOSE AGAPITO (PRESIDENT/DENTIST) |
| NPI Enumeration Date | 09/20/2010 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 308 | $4K |
| 2019 | 12 | $127.00 |
| 2020 | 12 | $110.00 |
| 2021 | 38 | $265.20 |
| 2024 | 13 | $184.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 43 | 43 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 118 | 118 | $1K |
| D0120 | Periodic oral evaluation - established patient | 32 | 32 | $993.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 159 | 74 | $573.60 |
| D0272 | Bitewings - two radiographic images | 31 | 31 | $346.00 |