SPARTAN DENTAL INC
NPI: 1699113746
· CRANSTON, RI 02920
· General Practice Dentistry
· NPI assigned 06/11/2013
Provider Details
| Authorized Official | KOUTROS, ELIAS (PRESIDENT) |
| NPI Enumeration Date | 06/11/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
264 |
$5K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
121 |
103 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
53 |
46 |
$828.00 |
| D0274 |
Bitewings - four radiographic images |
43 |
37 |
$814.00 |
| D0120 |
Periodic oral evaluation - established patient |
47 |
39 |
$390.00 |