SOUTHDALE DENTAL ASSOCIATES
NPI: 1285691220
· EDINA, MN 55435
· Dentist
· NPI assigned 04/26/2006
Provider Details
| Authorized Official | RAYMOND, JAMES (PRESIDENT PARTNER) |
| NPI Enumeration Date | 04/26/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
25 |
$497.64 |
| 2019 |
12 |
$340.68 |
| 2020 |
13 |
$0.00 |
| 2021 |
26 |
$340.08 |
| 2023 |
25 |
$586.74 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
50 |
49 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$156.96 |
| D9985 |
|
39 |
37 |
$0.00 |