NPI: 1871564054 · STATEN ISLAND, NY 10304 · Dental Clinic/Center · NPI assigned 01/27/2006
| Authorized Official | DE SILVA, SUJATHA (PRINCIPAL) |
| NPI Enumeration Date | 01/27/2006 |
Other providers sharing the same authorized official: DE SILVA, SUJATHA
| Provider | City | State | Total Paid |
|---|---|---|---|
| SUJATHA H DE SILVA DDS PC | PORT JERVIS | NY | $2K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 14 | $370.50 |
| 2019 | 25 | $436.06 |
| 2020 | 42 | $829.30 |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 81 | 80 | $2K |