SIMPLE MIRACLES DENTISTRY, LLC
NPI: 1952189136
· BOWIE, MD 20715
· General Practice Dentistry
· NPI assigned 09/19/2023
Provider Details
| Authorized Official | DICKS, SHANA (GENERAL DENTIST) |
| NPI Enumeration Date | 09/19/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
435 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
72 |
26 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
162 |
162 |
$9K |
| D1110 |
Prophylaxis - adult |
101 |
101 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
87 |
87 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$315.38 |