TODAY'S DENTAL 74TH PLAZA, LLC
NPI: 1407411507
· OMAHA, NE 68114
· General Practice Dentistry
· NPI assigned 05/03/2019
$333.20
Total Medicaid Paid
Provider Details
| Authorized Official | RISING, BRENT (OWNER DENTIST) |
| NPI Enumeration Date | 05/03/2019 |
Related Entities
Other providers sharing the same authorized official: RISING, BRENT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
14 |
$333.20 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$333.20 |