BURLESON PEDIATRIC DENTAL CENTER LLC

NPI: 1033841317 · BURLESON, TX 76028 · Dentist · NPI assigned 06/27/2022

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official COLE, MIKE controls 20+ related entities in our dataset. Read more

$82K

Total Medicaid Paid

4,533

Total Claims

4,458

Beneficiaries

Codes Billed

2023-01

First Month

2024-12

Last Month

Provider Details

Authorized Official	COLE, MIKE (VP INSURANCE PLAN MANAGEMENT)
NPI Enumeration Date	06/27/2022

Other providers sharing the same authorized official: COLE, MIKE

Provider	City	State	Total Paid
GENTLE DENTAL GRATIOT AVE PLLC	DETROIT	MI	$4.52M
PDOM ELKTON	ELKTON	MD	$4.44M
PDOM HAVRE DE GRACE	HAVRE DE GRACE	MD	$4.29M
DENTAL CENTER OF GOSHEN PLLC	GOSHEN	IN	$3.23M
GENTLE DENTAL GRAND RIVER PLLC	DETROIT	MI	$2.49M
PEDIATRIC DENTISTRY AND ORTHODONTICS OF MARYLAND LLC	GLEN BURNIE	MD	$1.99M
GENTLE DENTAL WESTLAND PLLC	WESTLAND	MI	$1.60M
KONIKOFF DENTAL ASSOCIATES, INC.	VIRGINIA BEACH	VA	$1.34M
DENTAL CARE ALLIANCE LLC	SARASOTA	FL	$838K
GENTLE DENTAL SHORES PLLC	SAINT CLAIR SHORES	MI	$754K
FAMILY DENTAL GROUP ASSOCIATES PLLC	FLINT	MI	$703K
GENTLE DENTAL WARREN PLLC	WARREN	MI	$559K
GENTLE DENTAL BAY PLLC	NEW BALTIMORE	MI	$305K
GENTLE DENTAL THORNDALE LLC	THORNDALE	PA	$237K
GENTLE DENTAL SHELBY PLLC	SHELBY TOWNSHIP	MI	$150K
WESTLAND- WAYNE P.C.	WESTLAND	MI	$70K
DETROIT - GRATIOT P.C.	DETROIT	MI	$24K
DENTAL ONE ASSOCIATES (WESTMINSTER) PC	WESTMINSTER	MD	$7K
DENTAL ONE ASSOCIATES WOODBRIDGE PC	WOODBRIDGE	VA	$3K
GERMANTOWN DENTAL ASSOCIATES	PHILADELPHIA	PA	$2K

Year	Claims	Total Paid
2023	3,126	$59K
2024	1,407	$23K

Code	Description	Claims	Beneficiaries	Total Paid
D0120	Periodic oral evaluation - established patient	950	937	$26K
D1120	Prophylaxis - child	375	371	$13K
D1110	Prophylaxis - adult	220	216	$12K
D1206	Topical application of fluoride varnish	793	783	$11K
D0274	Bitewings - four radiographic images	224	220	$7K
D0220	Intraoral - periapical first radiographic image	455	447	$5K
D0272	Bitewings - two radiographic images	163	161	$4K
D0230	Intraoral - periapical each additional radiographic image	224	209	$2K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	29	28	$704.86
D0350		12	12	$128.66
D0603		1,088	1,074	$0.00