SMILE LOFT BETHESDA LLC
NPI: 1811441108
· BETHESDA, MD 20814
· General Practice Dentistry
· NPI assigned 08/04/2016
$323.96
Total Medicaid Paid
Provider Details
| Authorized Official | RAI, VAIBHAV (OWNER) |
| NPI Enumeration Date | 08/04/2016 |
Related Entities
Other providers sharing the same authorized official: RAI, VAIBHAV
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2021 |
13 |
$323.96 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$323.96 |