CONANT STREET DENTAL LLC
NPI: 1710382676
· DANVERS, MA 01923
· General Practice Dentistry
· NPI assigned 11/04/2014
Provider Details
| Authorized Official | SONG, SEUNGHEE (DENTIST) |
| NPI Enumeration Date | 11/04/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
181 |
$8K |
| 2019 |
102 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
197 |
192 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
49 |
49 |
$981.00 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$840.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$444.00 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$429.00 |