LOAN MAI NGUYEN DDS INC
NPI: 1760221048
· SAN JOSE, CA 95122
· General Practice Dentistry
· NPI assigned 05/24/2024
$354.00
Total Medicaid Paid
Provider Details
| Authorized Official | NGUYEN, LOAN (MANAGER) |
| NPI Enumeration Date | 05/24/2024 |
Related Entities
Other providers sharing the same authorized official: NGUYEN, LOAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
70 |
$354.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
16 |
15 |
$192.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
41 |
18 |
$162.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$0.00 |