SOUTHMORE DENTAL PA
NPI: 1992495485
· PASADENA, TX 77502
· General Practice Dentistry
· NPI assigned 05/09/2023
Provider Details
| Authorized Official | TRAN, LINDA (MANAGER) |
| NPI Enumeration Date | 05/09/2023 |
Related Entities
Other providers sharing the same authorized official: TRAN, LINDA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
962 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
116 |
116 |
$3K |
| D0240 |
|
256 |
128 |
$2K |
| D1120 |
Prophylaxis - child |
59 |
59 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
138 |
138 |
$2K |
| D1110 |
Prophylaxis - adult |
31 |
31 |
$2K |
| D0272 |
Bitewings - two radiographic images |
56 |
56 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
121 |
115 |
$1K |
| D0274 |
Bitewings - four radiographic images |
32 |
32 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
77 |
77 |
$668.74 |
| D0601 |
|
76 |
75 |
$0.00 |