SOUTH DAVIS PEDIATRIC DENTISTRY LLC
NPI: 1841891462
· BOUNTIFUL, UT 84010
· Pediatric Dentist
· NPI assigned 11/02/2020
Provider Details
| Authorized Official | ODION, CHARLES (OWNER) |
| NPI Enumeration Date | 11/02/2020 |
Related Entities
Other providers sharing the same authorized official: ODION, CHARLES
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
304 |
$9K |
| 2024 |
1,749 |
$57K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
502 |
498 |
$22K |
| D0120 |
Periodic oral evaluation - established patient |
502 |
499 |
$14K |
| D0272 |
Bitewings - two radiographic images |
382 |
379 |
$10K |
| D1206 |
Topical application of fluoride varnish |
461 |
456 |
$10K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
63 |
12 |
$5K |
| D0274 |
Bitewings - four radiographic images |
47 |
47 |
$2K |
| D1351 |
Sealant - per tooth |
70 |
12 |
$2K |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$665.31 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$592.76 |