FORTSON DENTAL OAK PARK P.C.
NPI: 1336610633
· OAK PARK, MI 48237
· Dental Clinic/Center
· NPI assigned 12/12/2018
$726.55
Total Medicaid Paid
Provider Details
| Authorized Official | SOLI, JAMIE (OFFICE MANAGER) |
| NPI Enumeration Date | 12/12/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
12 |
$366.55 |
| 2024 |
12 |
$360.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$366.55 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$360.00 |