PUEBLO DENTAL SERVICES LLC
NPI: 1992577860
· PUEBLO, CO 81008
· General Practice Dentistry
· NPI assigned 10/24/2023
$233K
Total Medicaid Paid
Provider Details
| Authorized Official | KAZEMI, MEHRON (OWNER) |
| NPI Enumeration Date | 10/24/2023 |
Related Entities
Other providers sharing the same authorized official: KAZEMI, MEHRON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
558 |
$233K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D2740 |
Crown - porcelain/ceramic |
234 |
52 |
$195K |
| D2950 |
|
219 |
50 |
$30K |
| D4342 |
|
27 |
13 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
78 |
78 |
$4K |