DAKOTA PEDIATRIC DENTISTRY
NPI: 1487824991
· FARGO, ND 58104
· General Practice Dentistry
· NPI assigned 03/11/2008
$122K
Total Medicaid Paid
Provider Details
| Authorized Official | HOGE, CHAD (VICE PRESIDENT) |
| NPI Enumeration Date | 03/11/2008 |
Related Entities
Other providers sharing the same authorized official: HOGE, CHAD
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,329 |
$35K |
| 2019 |
1,498 |
$38K |
| 2020 |
1,215 |
$28K |
| 2021 |
745 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,257 |
1,167 |
$46K |
| D1206 |
Topical application of fluoride varnish |
1,638 |
1,522 |
$33K |
| D0120 |
Periodic oral evaluation - established patient |
1,375 |
1,269 |
$31K |
| D0272 |
Bitewings - two radiographic images |
425 |
382 |
$10K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
79 |
67 |
$2K |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$714.36 |