CENTRAL PARK DENTISTRY
NPI: 1386164622
· CHARLES CITY, IA 50616
· General Practice Dentistry
· NPI assigned 06/27/2017
$386.81
Total Medicaid Paid
Provider Details
| Authorized Official | WENDLAND, DAWN (FRONT OFFICE COORDINTOR) |
| NPI Enumeration Date | 06/27/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
27 |
$386.81 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$229.18 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$157.63 |