STANSBURY PARK PEDIATRIC DENTISTRY
NPI: 1487295218
· STANSBURY PARK, UT 84074
· Pediatric Dentist
· NPI assigned 10/02/2019
Provider Details
| Authorized Official | SHIGLEY, ALISHA (OFFICE MANAGER) |
| NPI Enumeration Date | 10/02/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
57 |
$3K |
| 2021 |
12 |
$77.94 |
| 2022 |
188 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
24 |
24 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$2K |
| D0272 |
Bitewings - two radiographic images |
56 |
55 |
$867.44 |
| D1120 |
Prophylaxis - child |
98 |
98 |
$251.92 |
| D1206 |
Topical application of fluoride varnish |
67 |
67 |
$104.83 |