NOVA SOUTHEASTERN UNIVERSITY, INC.
NPI: 1548406812
· HOLLYWOOD, FL 33021
· Pediatric Dentist
· NPI assigned 12/17/2008
$942.38
Total Medicaid Paid
Provider Details
| Authorized Official | OLLER, ROBERT (CLINICAL OPERATIONS) |
| Parent Organization | NOVA SOUTHEASTERN UNIVERSITY, INC |
| NPI Enumeration Date | 12/17/2008 |
Related Entities
Other providers sharing the same authorized official: OLLER, ROBERT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
60 |
$942.38 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$942.38 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$0.00 |
| D1330 |
|
17 |
17 |
$0.00 |