NOVA DENTAL NORTH LLC
NPI: 1982085270
· CROMWELL, CT 06416
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 06/12/2015
$141K
Total Medicaid Paid
Provider Details
| Authorized Official | IJAZ, ASMA (OWNER) |
| NPI Enumeration Date | 06/12/2015 |
Related Entities
Other providers sharing the same authorized official: IJAZ, ASMA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
527 |
$15K |
| 2019 |
711 |
$22K |
| 2020 |
224 |
$6K |
| 2021 |
686 |
$18K |
| 2022 |
784 |
$21K |
| 2023 |
848 |
$26K |
| 2024 |
1,063 |
$34K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,207 |
1,173 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,196 |
1,174 |
$27K |
| D1110 |
Prophylaxis - adult |
719 |
699 |
$25K |
| D1120 |
Prophylaxis - child |
485 |
476 |
$21K |
| D0274 |
Bitewings - four radiographic images |
544 |
535 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
397 |
373 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
178 |
164 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
43 |
41 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
74 |
71 |
$893.57 |