SUMMIT DENTAL HEALTH - Q STREET LLC · NPI 1174931638

SUMMIT DENTAL HEALTH - Q STREET LLC

NPI: 1174931638 · OMAHA, NE 68127 · General Practice Dentistry · NPI assigned 07/29/2014

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official JAMES, STEVE controls 20+ related entities in our dataset. Read more

$39K

Total Medicaid Paid

2,588

Total Claims

2,398

Beneficiaries

Codes Billed

2018-01

First Month

2018-09

Last Month

Authorized Official	JAMES, STEVE (CFO)
NPI Enumeration Date	07/29/2014

Other providers sharing the same authorized official: JAMES, STEVE

Provider	City	State	Total Paid
KIDS DENTISTRY-JEFFERSON MALL,PLLC	LOUISVILLE	KY	$9.77M
KIDS DENTISTRY-JEFFERSONVILLE, LLC	JEFFERSONVILLE	IN	$6.37M
KIDS DENTISTRY-NEW ALBANY	NEW ALBANY	IN	$4.61M
KIDS DENTISTREE - WESTPORT VILLAGE	LOUISVILLE	KY	$4.19M
MORTENSON FAMILY DENTAL CENTER-VALLEY STATION	LOUISVILLE	KY	$3.06M
ORAL SURGERY GROUP OF SOUTHERN INDIANA, LLC	NEW ALBANY	IN	$1.99M
SUMMIT DENTAL HEALTH - E STREET LLC	OMAHA	NE	$1.99M
SUMMIT DENTAL HEALTH - BRENTWOOD LLC	LA VISTA	NE	$1.79M
MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, PLLC	LOUISVILLE	KY	$1.77M
SUMMIT DENTAL HEALTH - DUNDEE LLC	OMAHA	NE	$1.71M
SUMMIT DENTAL HEALTH - TOWNE LLC	BELLEVUE	NE	$1.60M
SUMMIT DENTAL HEALTH - CENTER LLC	OMAHA	NE	$1.28M
SUMMIT DENTAL HEALTH - OAKVIEW, LLC	OMAHA	NE	$1.21M
MORTENSON FAMILY DENTAL CENTER	LOUISVILLE	KY	$1.10M
MORTENSON FAMILY DENTAL CENTER - VERSAILLES, PLLC	VERSAILLES	KY	$793K
MORTENSON FAMILY DENTAL CENTER	CRESTWOOD	KY	$631K
MORTENSONFAMILYDENTALCENTER-BUECHEL, PLLC	LOUISVILLE	KY	$554K
MORTENSON FAMILY DENTAL CENTER - ELIZABETHTOWN NORTH, PLLC	ELIZABETHTOWN	KY	$546K
SUMMIT DENTAL HEALTH - OLD MARKET LLC	OMAHA	NE	$543K
CHILDREN'S DENTAL CENTER OF BIG SPRING, PLLC	BIG SPRING	TX	$481K

Year	Claims	Total Paid
2018	2,588	$39K

Code	Description	Claims	Beneficiaries	Total Paid
D1206	Topical application of fluoride varnish	347	341	$6K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	78	52	$6K
D0120	Periodic oral evaluation - established patient	283	273	$6K
D1120	Prophylaxis - child	202	199	$5K
D1110	Prophylaxis - adult	131	125	$4K
D0274	Bitewings - four radiographic images	299	287	$4K
D0210	Intraoral - complete series of radiographic images	61	61	$3K
D0220	Intraoral - periapical first radiographic image	449	420	$2K
D0230	Intraoral - periapical each additional radiographic image	476	392	$2K
D0150	Comprehensive oral evaluation - new or established patient	70	70	$1K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	37	28	$924.00
D0272	Bitewings - two radiographic images	39	39	$429.00
D0330	Panoramic radiographic image	116	111	$360.00