MISTY PARTNERSHIP
NPI: 1104146695
· WASHINGTON, DC 20019
· General Practice Dentistry
· NPI assigned 06/07/2010
$300.00
Total Medicaid Paid
Provider Details
| Authorized Official | EILAND, DERRICK (PARTNER) |
| NPI Enumeration Date | 06/07/2010 |
Related Entities
Other providers sharing the same authorized official: EILAND, DERRICK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
12 |
$300.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$300.00 |