NPI: 1831966936 · SOUTHINGTON, CT 06489 · General Practice Dentistry · NPI assigned 12/08/2023
| Authorized Official | BELISLE, RAYMOND (CHIEF OPERATING OFFICER) |
| Parent Organization | GORGEOUS SMILES SOUTHINGTON |
| NPI Enumeration Date | 12/08/2023 |
Other providers sharing the same authorized official: BELISLE, RAYMOND
| Provider | City | State | Total Paid |
|---|---|---|---|
| GORGEOUS SMILES DENTAL HARTFORD | HARTFORD | CT | $147K |
| GORGEOUS SMILES DENTAL, PC | MANCHESTER | CT | $116K |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 357 | $6K |
| 2024 | 2,957 | $74K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | 326 | 105 | $15K | |
| D1110 | 369 | 248 | $9K | |
| D7210 | 302 | 69 | $9K | |
| D0140 | 444 | 267 | $8K | |
| D0274 | 284 | 221 | $7K | |
| D0120 | 369 | 284 | $7K | |
| D7140 | 192 | 43 | $6K | |
| D2393 | 83 | 28 | $4K | |
| D2391 | 67 | 27 | $4K | |
| D1208 | 215 | 141 | $3K | |
| D0330 | 181 | 93 | $3K | |
| D0220 | 303 | 191 | $2K | |
| D0150 | 124 | 67 | $2K | |
| D0210 | 38 | 16 | $590.85 | |
| D0230 | 17 | 13 | $176.97 |