DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC

NPI: 1073204012 · PHOENIX, AZ 85037 · General Practice Dentistry · NPI assigned 05/19/2023

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official ASHMORE, GLENN controls 20+ related entities in our dataset. Read more

$17K

Total Medicaid Paid

1,820

Total Claims

776

Beneficiaries

Codes Billed

2024-03

First Month

2024-12

Last Month

Provider Details

Authorized Official	ASHMORE, GLENN (OWNER / CEO)
NPI Enumeration Date	05/19/2023

Other providers sharing the same authorized official: ASHMORE, GLENN

Provider	City	State	Total Paid
DR GLENN A ASHMORE INC	OKC	OK	$6.19M
DENTAL DEPOT OF 10004 SOUTH MEMORIAL DRIVE PLLC	OKLAHOMA CITY	OK	$5.17M
GLENN C. ASHMORE DDS, INC.	SAN DIEGO	CA	$5.05M
DENTAL DEPOT SOUTHERN HILLS 71ST & JACKSON	TULSA	OK	$4.27M
DENTAL DEPOT OF TULSA	TULSA	OK	$4.24M
DENTAL DEPOT OF I-44 & HARVARD, PLLC	TULSA	OK	$4.14M
DENTAL DEPOT OF NORMAN, PLLC	NORMAN	OK	$3.92M
ASHMORE DENTAL CORPORATION	SAN DIEGO	CA	$3.65M
DENTAL DEPOT 62ND & SOUTH WESTERN PLLC	OKLAHOMA CITY	OK	$3.46M
DENTAL DEPOT OF 63RD & NW EXPRESSWAY, PLLC	OKLAHOMA CITY	OK	$3.41M
GLENN CASEY ASHMORE DENTAL CORP.	SAN DIEGO	CA	$3.35M
DENTAL DEPOT OF BROKEN ARROW, PLLC	BROKEN ARROW	OK	$3.21M
DENTAL DEPOT OF 145TH & N. PENN	OKLAHOMA CITY	OK	$3.17M
DENTL DEPOT RENO AND ROCKWELL, PLLC	OKLAHOMA CITY	OK	$3.10M
G.C. ASHMORE DENTAL CORP.	SAN DIEGO	CA	$2.90M
DENTAL DEPOT OF 36TH & TECUMSEH, PLLC	NORMAN	OK	$1.64M
G. ASHMORE DENTAL CORP.	SAN DIEGO	CA	$895K
GCA ASHMORE DENTAL CORP	ESCONDIDO	CA	$792K
C. ASHMORE DENTAL CORP.	SAN DIEGO	CA	$186K
ARTHURS DENTAL OF PHOENIX PLLC	PHOENIX	AZ	$42K

Year	Claims	Total Paid
2024	1,820	$17K

Code	Description	Claims	Beneficiaries	Total Paid
D0230	Intraoral - periapical each additional radiographic image	1,094	172	$5K
D0330	Panoramic radiographic image	142	119	$4K
D0150	Comprehensive oral evaluation - new or established patient	88	80	$2K
D0220	Intraoral - periapical first radiographic image	256	196	$2K
D0274	Bitewings - four radiographic images	109	92	$2K
D1206	Topical application of fluoride varnish	95	88	$2K
D0140	Limited oral evaluation - problem focused	18	16	$495.88
D1120	Prophylaxis - child	18	13	$242.64