LGM DDS LLC
NPI: 1861824104
· ELKRIDGE, MD 21075
· General Practice Dentistry
· NPI assigned 08/08/2013
Provider Details
| Authorized Official | GOITOM, MEHRET (OFFICE MANAGER) |
| NPI Enumeration Date | 08/08/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
166 |
$5K |
| 2019 |
220 |
$6K |
| 2020 |
207 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
289 |
282 |
$7K |
| D1120 |
Prophylaxis - child |
114 |
114 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
149 |
147 |
$4K |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$755.95 |
| D1330 |
|
28 |
26 |
$156.00 |