NPI: 1104364710 · AUSTIN, TX 78749 · Orthodontics and Dentofacial Orthopedic Dentist · NPI assigned 02/02/2017
Authorized official MONTGOMERY, MARTY controls 11+ related entities in our dataset. Read more
| Authorized Official | MONTGOMERY, MARTY (OWNER) |
| NPI Enumeration Date | 02/02/2017 |
Other providers sharing the same authorized official: MONTGOMERY, MARTY
| Provider | City | State | Total Paid |
|---|---|---|---|
| NORTH AUSTIN PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $874K |
| LONE STAR PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $746K |
| ELGIN PEDIATRIC DENTAL PLLC | ELGIN | TX | $397K |
| KYLE PEDIATRIC DENTAL | KYLE | TX | $352K |
| LSPD AT KILLEEN, PLLC | KILLEEN | TX | $259K |
| T & S OMFS PLLC | AUSTIN | TX | $188K |
| LAKEWAY PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $134K |
| CENTRAL AUSTIN PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $122K |
| LSPD AT COVE PLLC | COPPERAS COVE | TX | $106K |
| DRIPPING SPRINGS PEDIATRIC DENTAL, PLLC | DRIPPING SPRINGS | TX | $28K |
| CHILDREN'S DENTAL RANCH OF NEW BRAUNFELS, PLLC | NEW BRAUNFELS | TX | $22K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 715 | $16K |
| 2021 | 2,659 | $54K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 544 | 121 | $14K |
| D0145 | Oral evaluation for a patient under three years of age | 71 | 71 | $10K |
| D1120 | Prophylaxis - child | 250 | 246 | $9K |
| D0120 | Periodic oral evaluation - established patient | 274 | 269 | $7K |
| D0272 | Bitewings - two radiographic images | 230 | 223 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 343 | 337 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 403 | 391 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 464 | 369 | $4K |
| D1110 | Prophylaxis - adult | 68 | 66 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 19 | 12 | $2K |
| D0274 | Bitewings - four radiographic images | 67 | 66 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 50 | 48 | $2K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 62 | 58 | $2K |
| D0330 | Panoramic radiographic image | 64 | 62 | $834.64 |
| D0603 | 465 | 461 | $0.00 |