LAKESHORE FAMILY DENTISTRY PA
NPI: 1669585154
· WHITE BEAR LAKE, MN 55110
· General Practice Dentistry
· NPI assigned 08/17/2006
$521.73
Total Medicaid Paid
Provider Details
| Authorized Official | DELGRECO, JONNI (OFFICE MANAGER) |
| NPI Enumeration Date | 08/17/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$263.34 |
| 2020 |
30 |
$258.39 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
26 |
26 |
$521.73 |
| D9985 |
|
16 |
14 |
$0.00 |