NPI: 1861063240 · STAMFORD, CT 06902 · Dentist · NPI assigned 07/07/2021
| Authorized Official | RANDOLPH, THEODORE (COO) |
| NPI Enumeration Date | 07/07/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 1,624 | $42K |
| 2024 | 2,862 | $103K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 2,364 | 306 | $53K |
| D0150 | Comprehensive oral evaluation - new or established patient | 449 | 404 | $29K |
| D0210 | Intraoral - complete series of radiographic images | 422 | 381 | $27K |
| D1110 | Prophylaxis - adult | 297 | 257 | $18K |
| D1206 | Topical application of fluoride varnish | 416 | 402 | $8K |
| D2940 | 77 | 31 | $5K | |
| D1310 | 358 | 346 | $2K | |
| D1354 | 31 | 13 | $1K | |
| D0120 | Periodic oral evaluation - established patient | 23 | 22 | $731.88 |
| D1330 | 16 | 15 | $605.10 | |
| D9987 | 17 | 16 | $74.50 | |
| D0603 | 16 | 15 | $0.00 |