SMILE, IT'S HEALTHY L.L.C.
NPI: 1740719004
· FAIRWAY, KS 66205
· Public Health Dentist
· NPI assigned 06/08/2017
Provider Details
| Authorized Official | MCDOUGALD, MARK (PRESIDENT) |
| NPI Enumeration Date | 06/08/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
65 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
26 |
26 |
$708.61 |
| D1206 |
Topical application of fluoride varnish |
26 |
26 |
$442.91 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$348.00 |