NPI: 1437872777 · SANTA MARIA, CA 93454 · Orthodontics and Dentofacial Orthopedic Dentist · NPI assigned 09/21/2022
| Authorized Official | TAM, KEITH (GENERAL PARTNER) |
| NPI Enumeration Date | 09/21/2022 |
Other providers sharing the same authorized official: TAM, KEITH
| Provider | City | State | Total Paid |
|---|---|---|---|
| KTAM DDS DENTAL CORP | SANTA MARIA | CA | $83K |
| KEITH H TAM DDS INC | NEWPORT BEACH | CA | $43K |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 15 | $990.00 |
| 2023 | 174 | $6K |
| 2024 | 44 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 61 | 61 | $3K |
| D0120 | Periodic oral evaluation - established patient | 45 | 45 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 33 | 33 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 62 | 62 | $840.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 32 | 15 | $129.60 |