ADVANCED FAMILY DENTISTRY LLC
NPI: 1558133512
· ANKENY, IA 50023
· General Practice Dentistry
· NPI assigned 10/24/2023
$599.29
Total Medicaid Paid
Provider Details
| Authorized Official | BLAND, LUCAS (COO) |
| Parent Organization | VIDENTA, LLC |
| NPI Enumeration Date | 10/24/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
17 |
$201.36 |
| 2024 |
13 |
$397.93 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$397.93 |
| D1206 |
Topical application of fluoride varnish |
17 |
12 |
$201.36 |