HAVEN DENTAL CORPORATION
NPI: 1215641584
· HARRISON, AR 72601
· General Practice Dentistry
· NPI assigned 01/10/2023
$839.25
Total Medicaid Paid
Provider Details
| Authorized Official | RUBISCH, JOSHUA (PRESIDENT) |
| NPI Enumeration Date | 01/10/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
15 |
$609.85 |
| 2024 |
17 |
$229.40 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
15 |
15 |
$609.85 |
| D0120 |
Periodic oral evaluation - established patient |
17 |
13 |
$229.40 |