ASCENSION DEPAUL SERVICES
NPI: 1689890063
· GOULD, AR 71643
· General Practice Dentistry
· NPI assigned 04/17/2007
Provider Details
| Authorized Official | GOODGAME, LISA (CFO) |
| Parent Organization | ASCENSION DEPAUL SERVICES |
| NPI Enumeration Date | 04/17/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
111 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
69 |
56 |
$1K |
| D0272 |
Bitewings - two radiographic images |
23 |
17 |
$340.00 |
| D1206 |
Topical application of fluoride varnish |
19 |
14 |
$279.30 |