NPI: 1326174319 · SANTA ROSA, CA 95407 · Dental Clinic/Center · NPI assigned 02/26/2007
Authorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more
| Authorized Official | ANDERSON, DONALD (ASSISTANT SECRETARY OF ENROLLMENTS) |
| Parent Organization | ST JOSEPH HEALTH SYSTEM |
| NPI Enumeration Date | 02/26/2007 |
Other providers sharing the same authorized official: ANDERSON, DONALD
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,976 | $41K |
| 2019 | 1,196 | $31K |
| 2020 | 1,124 | $44K |
| 2021 | 1,483 | $43K |
| 2022 | 2,683 | $106K |
| 2023 | 927 | $39K |
| 2024 | 1,056 | $44K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 1,995 | 1,981 | $111K |
| D1120 | Prophylaxis - child | 2,367 | 2,350 | $97K |
| D1206 | Topical application of fluoride varnish | 2,905 | 2,884 | $39K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 447 | 329 | $30K |
| D0150 | Comprehensive oral evaluation - new or established patient | 293 | 293 | $19K |
| D0274 | Bitewings - four radiographic images | 728 | 728 | $15K |
| D1310 | 245 | 245 | $11K | |
| D1351 | Sealant - per tooth | 372 | 138 | $7K |
| D0272 | Bitewings - two radiographic images | 631 | 631 | $7K |
| D9993 | 114 | 114 | $5K | |
| D1320 | 226 | 225 | $2K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 40 | 39 | $2K |
| D0603 | 69 | 69 | $1K | |
| D1208 | Topical application of fluoride, excluding varnish | 13 | 13 | $164.00 |