FAIR OAKS DENTAL, PA
NPI: 1194901744
· FAIR OAKS RANCH, TX 78015
· General Practice Dentistry
· NPI assigned 01/14/2008
$640.75
Total Medicaid Paid
Provider Details
| Authorized Official | TRAN, HUYEN (PRESIDENT) |
| NPI Enumeration Date | 01/14/2008 |
Related Entities
Other providers sharing the same authorized official: TRAN, HUYEN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
33 |
$132.30 |
| 2022 |
40 |
$508.45 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
|
27 |
27 |
$323.40 |
| D0120 |
|
12 |
12 |
$317.35 |
| D0603 |
|
34 |
33 |
$0.00 |