DISTINCTIVE DENTAL SERVICES, PA
NPI: 1073780805
· HOWARD LAKE, MN 55349
· General Practice Dentistry
· NPI assigned 05/12/2008
Provider Details
| Authorized Official | THOENNES, MICHAEL (CEO) |
| Parent Organization | DISTINCTIVE DENTAL SERVICES, PA |
| NPI Enumeration Date | 05/12/2008 |
Related Entities
Other providers sharing the same authorized official: THOENNES, MICHAEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
178 |
$417.00 |
| 2019 |
91 |
$3K |
| 2020 |
30 |
$0.00 |
| 2021 |
208 |
$4K |
| 2022 |
135 |
$7K |
| 2023 |
38 |
$2K |
| 2024 |
14 |
$485.25 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
332 |
325 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
147 |
147 |
$2K |
| D0274 |
Bitewings - four radiographic images |
56 |
55 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
44 |
43 |
$283.84 |
| D1999 |
|
115 |
102 |
$0.00 |