LE-VIET DENTAL AND SURGICAL ARTS
NPI: 1215687538
· RANCHO CUCAMONGA, CA 91730
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 03/28/2022
$510.40
Total Medicaid Paid
Provider Details
| Authorized Official | LE, NICK (OWNER DENTIST / CEO) |
| NPI Enumeration Date | 03/28/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
44 |
$510.40 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0350 |
|
29 |
12 |
$278.40 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$232.00 |