CONDON DENTAL SERVICES
NPI: 1871548925
· ODESSA, WA 99159
· General Practice Dentistry
· NPI assigned 05/24/2006
$622.70
Total Medicaid Paid
Provider Details
| Authorized Official | CONDON, MICHAEL (OWNER) |
| Parent Organization | CONDON DENTAL SERVICES, PS |
| NPI Enumeration Date | 05/24/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
38 |
$622.70 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
26 |
26 |
$360.17 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$262.53 |