SEDATION & IMPLANT DENTISTRY
NPI: 1073787669
· SAINT PAUL, MN 55119
· General Practice Dentistry
· NPI assigned 04/15/2008
$443.17
Total Medicaid Paid
Provider Details
| Authorized Official | ANDRESON, KARL (OWNER) |
| NPI Enumeration Date | 04/15/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
100 |
$0.00 |
| 2021 |
141 |
$443.17 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
13 |
13 |
$443.17 |
| D9985 |
|
152 |
140 |
$0.00 |
| D1999 |
|
76 |
71 |
$0.00 |