DR WISDOM TEETH
NPI: 1992298533
· SAN TAN VALLEY, AZ 85143
· Dental Clinic/Center
· NPI assigned 06/08/2018
Provider Details
| Authorized Official | FENN, JEFFREY (OWNER) |
| NPI Enumeration Date | 06/08/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
369 |
$12K |
| 2021 |
533 |
$2K |
| 2022 |
244 |
$436.68 |
| 2023 |
325 |
$704.58 |
| 2024 |
29 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
84 |
28 |
$5K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
140 |
60 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
695 |
582 |
$2K |
| D0330 |
Panoramic radiographic image |
553 |
503 |
$2K |
| D9310 |
|
28 |
26 |
$33.13 |