DENTAL WELLNESS PA LLC
NPI: 1699421800
· PORTLAND, ME 04101
· General Practice Dentistry
· NPI assigned 02/25/2022
Provider Details
| Authorized Official | KIM, EUGENE (DENTIST/OWNER) |
| NPI Enumeration Date | 02/25/2022 |
Related Entities
Other providers sharing the same authorized official: KIM, EUGENE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
42 |
$3K |
| 2023 |
172 |
$10K |
| 2024 |
401 |
$26K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
190 |
179 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
82 |
43 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
79 |
76 |
$7K |
| D1110 |
Prophylaxis - adult |
108 |
106 |
$7K |
| D1206 |
Topical application of fluoride varnish |
109 |
107 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
31 |
31 |
$1K |
| D0190 |
|
16 |
15 |
$307.05 |