MODERN DENTAL PROFESSIONALS - UTAH, PC
NPI: 1740687706
· AMERICAN FORK, UT 84003
· Dentist
· NPI assigned 11/19/2014
Provider Details
| Authorized Official | MARTINEZ, LILIANA (CREDENTIALING DIRECTOR) |
| NPI Enumeration Date | 11/19/2014 |
Related Entities
Other providers sharing the same authorized official: MARTINEZ, LILIANA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
88 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$836.08 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$460.39 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$225.91 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$166.91 |
| D0220 |
Intraoral - periapical first radiographic image |
38 |
38 |
$13.98 |