MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY, P.A.

NPI: 1124393822 · ORANGE CITY, FL 32763 · Dentist · NPI assigned 03/13/2012

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official GOMEZ, STEPHANIE controls 20+ related entities in our dataset. Read more

$1.58M

Total Medicaid Paid

75,778

Total Claims

69,543

Beneficiaries

Codes Billed

2020-04

First Month

2024-12

Last Month

Provider Details

Authorized Official	GOMEZ, STEPHANIE (PROVIDER RELATIONS SPECIALIST)
NPI Enumeration Date	03/13/2012

Other providers sharing the same authorized official: GOMEZ, STEPHANIE

Provider	City	State	Total Paid
DENTISTRY FOR CHILDREN PC	YONKERS	NY	$4.59M
MAIN STREET CHILDREN'S DENTISTRY OF MIAMI LAKES, PLLC	MIAMI LAKES	FL	$2.59M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CLERMONT, PLLC	CLERMONT	FL	$2.38M
DENTAL CENTER AT FOREST HILL, PA	WEST PALM BEACH	FL	$2.29M
MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF PALMETTO BAY, PA	PALMETTO BAY	FL	$2.22M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CAPE CORAL, P.A.	CAPE CORAL	FL	$2.21M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF HOMESTEAD, P.A.	HOMESTEAD	FL	$2.10M
MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS WATERFORD LAKES PLLC	ORLANDO	FL	$1.82M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF FT. MYERS, P.A.	FORT MYERS	FL	$1.80M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WINTER PARK, PA	WINTER PARK	FL	$1.68M
DENTAL SPECIALTY CENTER OF FT. MYERS, PA	FORT MYERS	FL	$1.40M
PALM DENTAL CENTER, PA	HIALEAH	FL	$1.27M
MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF NAPLES, PA	NAPLES	FL	$1.16M
MAIN STREET CHILDREN'S DENTISTRY OF AVENTURA, PA	AVENTURA	FL	$1.06M
TDG DENTAL GROUP PLLC	WOODBRIDGE	VA	$1.01M
DENTAL CENTER AT BAPTIST, PA	MIAMI	FL	$851K
SUNRISE DENTAL GROUP P.A.	PLANTATION	FL	$833K
MAIN STREET CHILDREN'S DENTISTRY OF JUPITER, PA	JUPITER	FL	$824K
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF SOUTH BROWARD, PA	COOPER CITY	FL	$717K
CHILDREN'S DENTAL CENTER OF KENDALL, PA	MIAMI	FL	$601K

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	8,125	8,094	$449K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2,798	1,453	$203K
D1110	Prophylaxis - adult	2,197	2,181	$159K
D0330	Panoramic radiographic image	1,476	1,465	$131K
D0150	Comprehensive oral evaluation - new or established patient	2,019	2,005	$99K
D7140	Extraction, erupted tooth or exposed root	1,413	831	$71K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	3,249	3,046	$65K
D2391	Resin-based composite - one surface, posterior, primary or permanent	1,947	1,060	$62K
D2930	Prefabricated stainless steel crown - primary tooth	548	337	$59K
D0120	Periodic oral evaluation - established patient	8,226	8,162	$55K
D1208	Topical application of fluoride, excluding varnish	9,896	9,839	$44K
D0274	Bitewings - four radiographic images	6,386	6,351	$36K
D0210	Intraoral - complete series of radiographic images	240	236	$26K
D0140	Limited oral evaluation - problem focused	728	704	$23K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	87	72	$17K
D1351	Sealant - per tooth	2,685	932	$17K
D1510		64	51	$14K
D0220	Intraoral - periapical first radiographic image	6,025	5,945	$14K
D1330		9,780	9,721	$9K
D9999	Unspecified adjunctive procedure, by report	391	391	$9K
D0272	Bitewings - two radiographic images	1,951	1,943	$8K
D0230	Intraoral - periapical each additional radiographic image	4,724	4,197	$5K
D3120		713	418	$3K
D0999	Unspecified diagnostic procedure, by report	51	51	$1K
D9920		25	24	$754.55
D1206	Topical application of fluoride varnish	34	34	$0.00