NPI: 1922156488 · KENSINGTON, MD 20895 · Dentist · NPI assigned 01/08/2007
| Authorized Official | TAN, DONNA (PRACTICE ADMINISTRATOR) |
| NPI Enumeration Date | 01/08/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 769 | $22K |
| 2019 | 484 | $14K |
| 2020 | 306 | $8K |
| 2021 | 197 | $5K |
| 2022 | 99 | $3K |
| 2023 | 130 | $4K |
| 2024 | 15 | $477.15 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 793 | 781 | $23K |
| D1206 | Topical application of fluoride varnish | 827 | 809 | $20K |
| D1120 | Prophylaxis - child | 172 | 171 | $7K |
| D1110 | Prophylaxis - adult | 63 | 63 | $4K |
| D1330 | 131 | 131 | $786.00 | |
| D0274 | Bitewings - four radiographic images | 14 | 14 | $308.00 |