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David Sbardellati (DDS)
2649 E. Chapman Ave., Orange, California, 92869
43 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Sealant
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Zoom (II) Teeth Whitening
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Basile Muntean (DDS)
1122 E Lincoln Avenue Ste. 114, Orange, California, 92865
63 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Valplast - Upper Flexible Partial Denture without Any Metal
- Valplast - Lower Flexible Partial Denture without Any Metal
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Muzaffar Qureshi (DDS)
2710 North Grand Avenue, Orange, California, 92705-7450
63 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Valplast - Upper Flexible Partial Denture without Any Metal
- Valplast - Lower Flexible Partial Denture without Any Metal
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Jae Kwon (DMD)
245 N. Glassell St. #A, Orange, California, 92866
63 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Valplast - Upper Flexible Partial Denture without Any Metal
- Valplast - Lower Flexible Partial Denture without Any Metal
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Joseph Sabet (DDS)
3138 E. Chapman Ave #A, Orange, California, 92869
63 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Valplast - Upper Flexible Partial Denture without Any Metal
- Valplast - Lower Flexible Partial Denture without Any Metal
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Grace Dy (DDS)
2010 north tustin st suite A, Orange, California, 92865
106 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Velscope Oral Cancer Screening ONLY
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Dental crown - Full gold crown
- Recement crown
- Veneers (composite bonding)
- Root Canal (Anterior/ Front Tooth)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Upper (Economic Dentures)
- Complete Upper Denture (Economic Full Denture)
- Complete Lower Denture (Economic Full Denture)
- Complete Upper Denture (Economic Full Denture) with Lower Partial Denture (with metal framework)
- Complete Upper Denture (Lucitone 199 Standard)
- Complete Lower Denture (Lucitone 199 Standard)
- Complete Lower Denture (Lucitone 199 Standard) with Upper Partial Denture (with metal framework)
- Complete Denture - Lower (Economic Dentures)
- Complete Lower Denture (Economic Full Denture) with Upper Partial Denture (with metal framework)
- Immediate Upper Denture
- Upper and Lower Immediate Denture Set (partial or complete)
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Upper and Lower Partial Dentures (with metal framework)
- Upper and Lower Partial Dentures (with metal framework)
- Lower Partial Denture with Metal Base
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Replace broken teeth per tooth on existing partial denture
- Add tooth to existing partial denture
- Add clasp to existing partial denture
- Interim complete denture (maxillary)
- Interim complete denture (mandibular)
- Interim partial denture (maxillary)
- Upper and Lower Partial Dentures - temporary thin resin base with small wire clasps (flipper / stay plate)
- Interim partial denture (mandibular)
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Dental Implant - Nobel BioCare
- Dental Implant - Straumann
- Dental Implant - AstraTech
- Dental Implant - 3i
- Dental Implant - Zimmer
- Dental Implant - Bicon
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Economy PFM Pontic for Bridge
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Economy Ceramic Pontic for Bridge
- Economy Ceramic Abutment for Bridge
- Economy Ceramic Two Unit Bridge
- Economy Ceramic Three Unit Bridge
- Economy Ceramic Four Unit Bridge
- Economy PFM Abutment for Bridge
- Economy PFM Two Unit Bridge
- Economy PFM Three Unit Bridge
- Economy PFM Four Unit Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Tooth Extraction and Bone Graft
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Lava Crowns are white zirconia crowns made by 3M
- Dental crown - Generic Zirconia crown
- e.max Crowns are white crowns made by Ivoclar Vivadent
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Captek Classical crowns are porcelain with an inner gold layer
- Dental crown (3D Ceric or E4D) - ceramic
- Empress Crowns are white ceramic crowns made by Ivoclar Vivadent

Carl Smetko (DDS)
720 n tustin ave #102, Santa Ana, California, 92705
63 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Valplast - Upper Flexible Partial Denture without Any Metal
- Valplast - Lower Flexible Partial Denture without Any Metal
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Amitiss Nasiri (DDS)
2781 W. MacArthur Blvd Ste. N, Santa Ana, California, 92704
71 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Root Canal (Anterior/ Front Tooth)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Replace broken teeth per tooth on existing partial denture
- Add tooth to existing partial denture
- Add clasp to existing partial denture
- Interim complete denture (maxillary)
- Interim complete denture (mandibular)
- Interim partial denture (maxillary)
- Interim partial denture (mandibular)
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Economy PFM Pontic for Bridge
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Economy PFM Abutment for Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic

Amisha Upadhyaya (DDS)
210 W First St # 110, Santa Ana, California, 92701
106 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Velscope Oral Cancer Screening ONLY
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Dental crown - Full gold crown
- Recement crown
- Veneers (composite bonding)
- Root Canal (Anterior/ Front Tooth)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Upper (Economic Dentures)
- Complete Upper Denture (Economic Full Denture)
- Complete Lower Denture (Economic Full Denture)
- Complete Upper Denture (Economic Full Denture) with Lower Partial Denture (with metal framework)
- Complete Upper Denture (Lucitone 199 Standard)
- Complete Lower Denture (Lucitone 199 Standard)
- Complete Lower Denture (Lucitone 199 Standard) with Upper Partial Denture (with metal framework)
- Complete Denture - Lower (Economic Dentures)
- Complete Lower Denture (Economic Full Denture) with Upper Partial Denture (with metal framework)
- Immediate Upper Denture
- Upper and Lower Immediate Denture Set (partial or complete)
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Upper and Lower Partial Dentures (with metal framework)
- Upper and Lower Partial Dentures (with metal framework)
- Lower Partial Denture with Metal Base
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Replace broken teeth per tooth on existing partial denture
- Add tooth to existing partial denture
- Add clasp to existing partial denture
- Interim complete denture (maxillary)
- Interim complete denture (mandibular)
- Interim partial denture (maxillary)
- Upper and Lower Partial Dentures - temporary thin resin base with small wire clasps (flipper / stay plate)
- Interim partial denture (mandibular)
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Dental Implant - Nobel BioCare
- Dental Implant - Straumann
- Dental Implant - AstraTech
- Dental Implant - 3i
- Dental Implant - Zimmer
- Dental Implant - Bicon
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Economy PFM Pontic for Bridge
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Economy Ceramic Pontic for Bridge
- Economy Ceramic Abutment for Bridge
- Economy Ceramic Two Unit Bridge
- Economy Ceramic Three Unit Bridge
- Economy Ceramic Four Unit Bridge
- Economy PFM Abutment for Bridge
- Economy PFM Two Unit Bridge
- Economy PFM Three Unit Bridge
- Economy PFM Four Unit Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Tooth Extraction and Bone Graft
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Lava Crowns are white zirconia crowns made by 3M
- Dental crown - Generic Zirconia crown
- e.max Crowns are white crowns made by Ivoclar Vivadent
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Captek Classical crowns are porcelain with an inner gold layer
- Dental crown (3D Ceric or E4D) - ceramic
- Empress Crowns are white ceramic crowns made by Ivoclar Vivadent

Shirley Santos (DDS)
17482 Irvine Blvd Suite B, Tustin, California, 92780
63 Procedures Added By This Provider.
Procedures Performed:
- Limited Exam (One specific problem) and 1 full-length x-ray
- New Patient Exam (Consultation)
- Velscope Oral Cancer Screening w/ New Patient Exam and Full-Mouth of X-rays
- Regular Cleaning / Prophylaxis - Adult
- Regular Cleaning / Prophylaxis - Child
- Sealant
- Spacer, band and loop, distal shoe
- Spacer, Nance appliance, lower lingual holding arch
- White filling, white filling on front tooth (1 surface), B, I
- White filling, white filling on front tooth (2 surface) IF, ML, DL, IL
- White filling, white filling on front tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on front tooth (4 surface) FIDL, DIFL, MIFL
- White filling, white filling on posterior tooth (1 surface), B, I
- White filling, white filling on posterior tooth (2 surface) OB, OL, MO, DO, BL
- White filling, white filling on posterior tooth (3 surface) OBL, DOL, MOD, MOL
- White filling, white filling on posterior tooth (4 surface) FIDL, DIFL, MIFL
- Dental crown (porcelain / ceramic substrate)
- Dental crown (porcelain fused to metal with at least 60% gold)
- Recement crown
- Veneers (composite bonding)
- Crown Lengthening Surgery
- Deep Cleaning (per quadrant of the mouth 4 teeth or more)
- Complete Upper and Lower Denture Set
- Complete Denture - Lower (Economic Dentures)
- Immediate Upper Denture
- Immediate Lower Denture
- Upper Partial Denture without Metal Base but with metal clasps and a resin base instead
- Lower Partial Denture without Metal Base but with metal clasps and a resin base instead
- Upper Partial Denture with Metal Base
- Lower Partial Denture with Metal Base
- Valplast - Upper Flexible Partial Denture without Any Metal
- Valplast - Lower Flexible Partial Denture without Any Metal
- Adjustment of a complete upper denture
- Adjustment of a complete lower denture
- Adjustment of a partial upper denture
- Adjustment of a partial lower denture
- Broken Complete Denture (pink base portion)
- Broken Complete Denture (white/ tooth base portion)
- Repair to the resin/acrylic (pink or purple) portion of a denture
- Repair the metal cast framework on a partial metal denture
- Repair a broken clasp or replace a broken clasp
- Endodontic endosseous implant
- Dental Implant, Abutment and All Porcelain/Ceramic Crown
- Dental Implant, Abutment and Porcelain fused over Metal Crown
- Removal of a Dental Implant
- Dental crown - Lava Or Zirconia (full ceramic crown without any metal) for missing teeth for a dental Bridge
- Extraction (Crown Only)
- Extraction (Erupted Tooth or Root)
- Extraction (Surgical Erupted Tooth)
- Extraction (Impacted Tooth by Soft Tissue)
- Extraction (Impacted Tooth by Partial Bony)
- Extraction (Impacted Tooth by Complete Bony)
- Extraction (Impacted Tooth by Complete Bony w/ complications)
- Braces for an Adolescent with Adult Teeth (Metal Brackets)
- Braces for Adult Teeth (Metal Brackets - Traditional)
- Nightguard
- Athletic Mouthguard
- Enamel Microabrasion
- In-Office 1 Hour Tooth Whitening - Generic Brand
- LAVA crown (zirconia/ceramic substrate)
- Dental crown - Generic Zirconia crown
- Dental crown (porcelain fused to gold) - CAPTEK with 84-88% gold
- Dental crown (3D Ceric or E4D) - ceramic





