FARGO DENTAL CORPORATION
NPI: 1609418987
· FONTANA, CA 92335
· Dental Clinic/Center
· NPI assigned 10/08/2019
Provider Details
| Authorized Official | FARGO, BASSAM (CO-OWNER/DENTIST) |
| NPI Enumeration Date | 10/08/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
92 |
$5K |
| 2023 |
150 |
$9K |
| 2024 |
1,041 |
$66K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
625 |
625 |
$41K |
| D0210 |
Intraoral - complete series of radiographic images |
512 |
512 |
$24K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
64 |
28 |
$7K |
| D1110 |
Prophylaxis - adult |
69 |
69 |
$6K |
| D1120 |
Prophylaxis - child |
13 |
13 |
$682.50 |