OAK HAVEN DENTAL
NPI: 1477094852
· RIVERTON, WY 82501
· General Practice Dentistry
· NPI assigned 03/17/2017
Provider Details
| Authorized Official | HAMMOND, JEFFERY (DENTIST/OWNER) |
| NPI Enumeration Date | 03/17/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
50 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
25 |
25 |
$840.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$350.00 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$350.00 |