SMILE FAMILY DENTIST
NPI: 1811240781
· NEW YORK, NY 10029
· General Practice Dentistry
· NPI assigned 10/17/2012
$931.75
Total Medicaid Paid
Provider Details
| Authorized Official | LETIZIA, JOHN (DENTIST) |
| NPI Enumeration Date | 10/17/2012 |
Related Entities
Other providers sharing the same authorized official: LETIZIA, JOHN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
40 |
$931.75 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
14 |
14 |
$535.50 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$276.25 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$120.00 |