NPI: 1700214350 · BOZEMAN, MT 59715 · General Practice Dentistry · NPI assigned 10/17/2013
| Authorized Official | GILLETTE, JANE (PRESIDENT) |
| NPI Enumeration Date | 10/17/2013 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 8,406 | $190K |
| 2019 | 6,824 | $166K |
| 2020 | 4,095 | $69K |
| 2021 | 6,338 | $126K |
| 2022 | 6,369 | $128K |
| 2023 | 11,412 | $241K |
| 2024 | 1,868 | $38K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 18,919 | 18,520 | $396K |
| D0190 | 8,985 | 8,655 | $194K | |
| D1351 | Sealant - per tooth | 6,652 | 2,128 | $181K |
| D9996 | 3,447 | 3,405 | $90K | |
| D0603 | 4,071 | 4,042 | $41K | |
| D0602 | 2,281 | 2,251 | $23K | |
| D1310 | 463 | 456 | $19K | |
| D1330 | 462 | 455 | $10K | |
| D9410 | 32 | 32 | $3K |