SOUTHCENTRAL FOUNDATION
NPI: 1124575022
· NIKOLAI, AK 99691
· General Practice Dentistry
· NPI assigned 09/08/2016
Provider Details
| Authorized Official | OLSEN, RONALD (EXECUTIVE VICE PRESIDENT FINANCE) |
| Parent Organization | SOUTHCENTRAL FOUNDATION |
| NPI Enumeration Date | 09/08/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
31 |
$3K |
| 2024 |
16 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
16 |
14 |
$3K |
| D0274 |
Bitewings - four radiographic images |
15 |
13 |
$120.54 |
| D0220 |
Intraoral - periapical first radiographic image |
16 |
13 |
$0.00 |