NPI: 1205404290 · SALT LAKE CITY, UT 84102 · Dental Clinic/Center · NPI assigned 06/15/2021
Authorized official BOWMAN, BENJAMIN controls 20+ related entities in our dataset. Read more
| Authorized Official | BOWMAN, BENJAMIN (OWNER/PARTNER) |
| NPI Enumeration Date | 06/15/2021 |
Other providers sharing the same authorized official: BOWMAN, BENJAMIN
| Provider | City | State | Total Paid |
|---|---|---|---|
| EL RENO DENTAL | EL RENO | OK | $649K |
| WOODLAND DENTISTRY AND BRACES | TULSA | OK | $552K |
| DENTAL LODGE OF PURCELL | PURCELL | OK | $465K |
| HARRAH DENTISTRY & BRACES | HARRAH | OK | $397K |
| KINGFISHER DENTAL PLLC | KINGFISHER | OK | $392K |
| CAPITOL HILL DENTISTRY & BRACES PLLC | OKLAHOMA CITY | OK | $295K |
| WEATHERFORD DENTISTRY & BRACES | WEATHERFORD | OK | $278K |
| DENTAL SURGERY CENTER OF MIDWEST CITY | OKLAHOMA CITY | OK | $249K |
| CHOCTAW DENTAL PLLC | CHOCTAW | OK | $214K |
| CLEVELAND DENTISTRY AND BRACES | CLEVELAND | OK | $210K |
| MUSTANG DENTISTRY & BRACES | MUSTANG | OK | $184K |
| SULPHUR DENTISTRY & BRACES | SULPHUR | OK | $152K |
| SAPULPA DENTISTRY AND BRACES | SAPULPA | OK | $136K |
| SHATTUCK DENTISTRY & BRACES | SHATTUCK | OK | $128K |
| I240 DENTAL, PLLC | OKLAHOMA CITY | OK | $125K |
| YUKON DENTISTRY & BRACES | YUKON | OK | $117K |
| SAND SPRINGS DENTISTRY AND BRACES | SAND SPRINGS | OK | $72K |
| MIDWEST CITY FAMILY DENTISTRY | OKLAHOMA CITY | OK | $60K |
| RICHFIELD FAMILY DENTAL | RICHFIELD | UT | $60K |
| ADA DENTISTRY AND BRACES | ADA | OK | $53K |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 700 | $18K |
| 2023 | 372 | $3K |
| 2024 | 221 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 55 | 54 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 369 | 309 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 62 | 53 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 460 | 210 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 28 | 12 | $2K |
| D1206 | Topical application of fluoride varnish | 130 | 129 | $601.59 |
| D0272 | Bitewings - two radiographic images | 55 | 54 | $581.90 |
| D0330 | Panoramic radiographic image | 13 | 13 | $227.73 |
| D1120 | Prophylaxis - child | 100 | 100 | $198.75 |
| D1330 | 21 | 12 | $0.00 |