MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CLERMONT, PLLC

NPI: 1275982670 · CLERMONT, FL 34711 · Pediatric Dentist · NPI assigned 06/07/2016

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$2.38M

Total Medicaid Paid

115,390

Total Claims

99,004

Beneficiaries

Codes Billed

2020-01

First Month

2024-12

Last Month

Provider Details

Authorized Official	GOMEZ, STEPHANIE (CREDENTIALING COORDINATOR)
NPI Enumeration Date	06/07/2016

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
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
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY, P.A.	ORANGE CITY	FL	$1.58M
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	18,882	17,339	$819K
D1110	Prophylaxis - adult	6,092	5,562	$343K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	4,914	2,169	$282K
D0150	Comprehensive oral evaluation - new or established patient	6,083	5,679	$233K
D0330	Panoramic radiographic image	2,056	1,942	$166K
D1208	Topical application of fluoride, excluding varnish	24,629	22,538	$75K
D0120	Periodic oral evaluation - established patient	18,479	16,836	$72K
D7140	Extraction, erupted tooth or exposed root	1,583	986	$64K
D2930	Prefabricated stainless steel crown - primary tooth	369	239	$58K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	3,941	3,424	$53K
D1351	Sealant - per tooth	5,676	1,485	$48K
D0140	Limited oral evaluation - problem focused	1,686	1,522	$37K
D0274	Bitewings - four radiographic images	11,228	10,196	$34K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	274	220	$34K
D0272	Bitewings - two radiographic images	7,479	7,002	$21K
D2391	Resin-based composite - one surface, posterior, primary or permanent	299	233	$17K
D9999	Unspecified adjunctive procedure, by report	566	566	$13K
D0210	Intraoral - complete series of radiographic images	127	127	$7K
D0220	Intraoral - periapical first radiographic image	269	257	$3K
D0999	Unspecified diagnostic procedure, by report	57	57	$1K
D1354		41	17	$389.89
D1330		550	546	$331.25
D0230	Intraoral - periapical each additional radiographic image	46	26	$236.90
D3120		64	36	$16.00