WHITEHALL DENTAL GROUP LLC

NPI: 1710463526 · WHITEHALL, PA 18052 · Dental Clinic/Center · NPI assigned 07/15/2018

$66K

Total Medicaid Paid

2,758

Total Claims

2,695

Beneficiaries

Codes Billed

2021-05

First Month

2024-12

Last Month

Provider Details

Authorized Official	PATEL, JIGNESH (OWNER)
NPI Enumeration Date	07/15/2018

Other providers sharing the same authorized official: PATEL, JIGNESH

Provider	City	State	Total Paid
GOLD STAR PEDIATRICS PA	NORTH PORT	FL	$344K
LEHIGHTON FAMILY DENTISTRY LLC	LEHIGHTON	PA	$285K
FAMILY MEDICAL CARE OF ST AUGUSTINE PA	ST AUGUSTINE	FL	$64K
J PATEL DDS INC	SAN FERNANDO	CA	$30K
BRUNSWICK SPINE AND PHYSICAL THERAPY LLC	NORTH BRUNSWICK	NJ	$36.43
HARIGOPAL INC	PORT CHARLOTTE	FL	$0.00
JIGNESH LLC	PERRY	FL	$0.00

Year	Claims	Total Paid
2021	13	$100.00
2024	2,745	$66K

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	441	435	$16K
D0274	Bitewings - four radiographic images	496	486	$14K
D0120	Periodic oral evaluation - established patient	335	335	$9K
D0150	Comprehensive oral evaluation - new or established patient	228	228	$7K
D0220	Intraoral - periapical first radiographic image	513	495	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	54	34	$3K
D0330	Panoramic radiographic image	85	85	$3K
D1206	Topical application of fluoride varnish	170	170	$3K
D1120	Prophylaxis - child	81	81	$2K
D0230	Intraoral - periapical each additional radiographic image	231	226	$2K
D9920		13	13	$1K
D2332		16	12	$1K
D9110		27	27	$790.04
D1330		68	68	$370.40