PARK AND DENTAL ASSOCIATES, LLC

NPI: 1801110861 · BELLEVUE, WA 98006 · General Practice Dentistry · NPI assigned 03/19/2010

$64K

Total Medicaid Paid

4,194

Total Claims

3,684

Beneficiaries

Codes Billed

2018-01

First Month

2019-07

Last Month

Provider Details

Authorized Official	PARK, YONG (DDS)
NPI Enumeration Date	03/19/2010

Other providers sharing the same authorized official: PARK, YONG

Provider	City	State	Total Paid
ACCESS DENTAL LLC	OLYMPIA	WA	$3.18M
UNIVERSITY PLACE SMILES PLLC	UNIVERSITY PLACE	WA	$3.06M
FEDERAL WAY DENTAL CLINIC	FEDERAL WAY	WA	$2.26M
WASHINGTON DENTAL FEDERAL WAY, LLC	FEDERAL WAY	WA	$1.07M
LYNNWOOD DENTAL CARE	LYNNWOOD	WA	$73K

Year	Claims	Total Paid
2018	2,480	$33K
2019	1,714	$31K

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	488	469	$16K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	169	46	$8K
D1208	Topical application of fluoride, excluding varnish	593	571	$7K
D0120	Periodic oral evaluation - established patient	299	290	$6K
D0150	Comprehensive oral evaluation - new or established patient	221	208	$5K
D0330	Panoramic radiographic image	204	196	$5K
D2391	Resin-based composite - one surface, posterior, primary or permanent	142	45	$5K
D0220	Intraoral - periapical first radiographic image	711	671	$5K
D0274	Bitewings - four radiographic images	572	547	$5K
D0230	Intraoral - periapical each additional radiographic image	749	599	$1K
D0140	Limited oral evaluation - problem focused	46	42	$742.95