PG PLAZE DENTAL

NPI: 1164837654 · HYATTSVILLE, MD 20782 · General Practice Dentistry · NPI assigned 06/24/2014

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official KRASNOV, ROSTISLAV controls 17+ related entities in our dataset. Read more

$3K

Total Medicaid Paid

175

Total Claims

175

Beneficiaries

Codes Billed

2018-08

First Month

2019-04

Last Month

Provider Details

Authorized Official	KRASNOV, ROSTISLAV (OWNER)
NPI Enumeration Date	06/24/2014

Other providers sharing the same authorized official: KRASNOV, ROSTISLAV

Provider	City	State	Total Paid
WESTLAND MALL DENTAL, PA	HIALEAH	FL	$923K
CROSS COUNTY MALL DENTAL, PA	WEST PALM BEACH	FL	$906K
BROWARD MALL DENTAL, PA	PLANTATION	FL	$620K
MIAMI INTERNATIONAL MALL DENTAL, PA	MIAMI	FL	$528K
ALTAMONTE MALL DENTAL PA	ALTAMONTE SPRINGS	FL	$395K
BRANDON MALL DENTAL P.A.	BRANDON	FL	$283K
EDISON MALL DENTAL P.A	FORT MYERS	FL	$255K
BOYNTON BEACH MALL DENTAL PA	BOYNTON BEACH	FL	$174K
SAWGRASS MILLS MALL DENTAL, PA	SUNRISE	FL	$169K
REGENCY SQUARE MALL DENTAL	JACKSONVILLE	FL	$163K
COUNTRYSIDE MALL DENTAL PA	CLEARWATER	FL	$155K
PEMBROKE LAKES MALL DENTAL PA	PEMBROKE PINES	FL	$62K
LAUDERHILL MALL DENTAL, PA	LAUDERHILL	FL	$31K
TYRONE SQUARE MALL DENTAL P.A	ST PETERSBURG	FL	$14K
WILLOWBROOK MALL DENTAL	HOUSTON	TX	$10K
METROTECH DENTAL ASSOCIATES PLLC	BROOKLYN	NY	$8K
WHEATON MALL DENTAL LLP	WHEATON	MD	$3K

Year	Claims	Total Paid
2018	83	$1K
2019	92	$1K

Code	Description	Claims	Beneficiaries	Total Paid
D1208	Topical application of fluoride, excluding varnish	48	48	$1K
D0120	Periodic oral evaluation - established patient	28	28	$814.16
D1330		46	46	$276.00
D0220	Intraoral - periapical first radiographic image	27	27	$243.00
D0230	Intraoral - periapical each additional radiographic image	26	26	$156.00