MADISON PARK DENTAL CENTER
NPI: 1831545102
· REXBURG, ID 83440
· General Practice Dentistry
· NPI assigned 05/05/2016
Provider Details
| Authorized Official | TALL, MARK (OWNER) |
| NPI Enumeration Date | 05/05/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
71 |
$1K |
| 2019 |
13 |
$0.00 |
| 2020 |
25 |
$32.79 |
| 2021 |
114 |
$2K |
| 2022 |
116 |
$480.39 |
| 2023 |
68 |
$426.71 |
| 2024 |
121 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
118 |
118 |
$7K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$902.77 |
| D0120 |
Periodic oral evaluation - established patient |
359 |
359 |
$515.75 |
| D0274 |
Bitewings - four radiographic images |
27 |
27 |
$56.61 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |