PEDIATRIC DENTISTRY OF PORTLAND LLC
NPI: 1679924526
· PORTLAND, OR 97232
· Pediatric Dentist
· NPI assigned 06/22/2016
Provider Details
| Authorized Official | LARSEN, NOEL (OWNER) |
| NPI Enumeration Date | 06/22/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
303 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
73 |
73 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
146 |
146 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
84 |
84 |
$2K |