NOBLE CREEK FAMILY DENITSTRY LLC
NPI: 1053688986
· NOBLESVILLE, IN 46060
· Dentist
· NPI assigned 11/21/2011
$965.98
Total Medicaid Paid
Provider Details
| Authorized Official | HUSEMAN, JAMES (OWNER) |
| NPI Enumeration Date | 11/21/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
42 |
$90.32 |
| 2020 |
12 |
$270.96 |
| 2021 |
34 |
$604.70 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
55 |
54 |
$702.25 |
| D1208 |
Topical application of fluoride, excluding varnish |
33 |
32 |
$263.73 |