MY SMILE EXPERIENCE
NPI: 1720617392
· SALEM, NH 03079
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 04/06/2020
$356.00
Total Medicaid Paid
Provider Details
| Authorized Official | BUTT, MOHAMED (PRESIDENT) |
| NPI Enumeration Date | 04/06/2020 |
Related Entities
Other providers sharing the same authorized official: BUTT, MOHAMED
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
24 |
$356.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$192.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$164.00 |