Mukunda N Dogiparthi, DMD
76 Northeastern Blvd Nashua, NH 03062
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $155 | 0% | $155 | Medium |
| Child Dental Cleaning | $120 | 0% | $120 | Medium |
| Fluoride - Topical Application | $67 | 0% | $67 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $278 | 0% | $278 | Medium |
| Sealant placed on the tooth surface to prevent decay | $80 | 0% | $80 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $120 | 0% | $120 | Medium |
| Periodic dental exam - established patient | $74 | 0% | $74 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $83 | 0% | $83 | Medium |
| X-Ray Dental - Complete intraoral series | $197 | 0% | $197 | Medium |
| X-Ray Dental - Four images - bitewings | $95 | 0% | $95 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $34 | 0% | $34 | Medium |
| X-Ray Dental - Two images - bitewings | $76 | 0% | $76 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $25 | 0% | $25 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $185 | 0% | $185 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $194 | 0% | $194 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $194 | 0% | $194 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $300 | 0% | $300 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $321 | 0% | $321 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $177 | 0% | $177 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $300 | 0% | $300 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $271 | 0% | $271 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $212 | 0% | $212 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $194 | 0% | $194 | Medium |