WAIKOLOA DENTAL CLINIC INC
NPI: 1003228982
· WAIKOLOA, HI 96738
· General Practice Dentistry
· NPI assigned 05/27/2014
Provider Details
| Authorized Official | FOSTVEDT, CRAIG (DENTIST/OWNER) |
| NPI Enumeration Date | 05/27/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
62 |
$2K |
| 2019 |
66 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
49 |
49 |
$2K |
| D1120 |
Prophylaxis - child |
50 |
50 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
29 |
29 |
$285.73 |