ADVANTAGE DENTAL ORAL HEALTH CENTER OF MASSACHUSETTS, PC

NPI: 1285284604 · WESTBOROUGH, MA 01581 · General Practice Dentistry · NPI assigned 09/17/2019

$143K

Total Medicaid Paid

5,086

Total Claims

4,706

Beneficiaries

Codes Billed

2020-02

First Month

2024-11

Last Month

Provider Details

Authorized Official	STUMP, JENELL (SR. LICENSING & CREDENTIALING)
NPI Enumeration Date	09/17/2019

Other providers sharing the same authorized official: STUMP, JENELL

Provider	City	State	Total Paid
AKRON SMILES YOUTH DENTISTRY LLC MICHAEL CRITES, DDS	AKRON	OH	$10.24M
THE INDIAN SPRINGS DENTAL CLINIC, LLC	KANSAS CITY	KS	$1.94M
SMALL SMILES OF WICHITA, LLC	WICHITA	KS	$576K
COMMUNITY CARE OF KENTUCKY INC.	LOUISVILLE	KY	$576K
TOPEKA DENTAL CLINIC, LLC	TOPEKA	KS	$235K
SAGER DENTAL PLLC	TEXAS CITY	TX	$57K
YOUNGSTOWN SMILES YOUTH DENTISTRY LLCMICHAEL CRITES DDS	YOUNGSTOWN	OH	$7K

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	1,622	1,478	$79K
D0120	Periodic oral evaluation - established patient	1,946	1,812	$43K
D1206	Topical application of fluoride varnish	273	242	$5K
D0220	Intraoral - periapical first radiographic image	350	317	$5K
D1120	Prophylaxis - child	110	106	$5K
D0274	Bitewings - four radiographic images	125	117	$4K
D0140	Limited oral evaluation - problem focused	27	26	$814.00
D0230	Intraoral - periapical each additional radiographic image	64	58	$703.80
D1208	Topical application of fluoride, excluding varnish	13	13	$377.00
D1330		238	230	$0.00
D0601		73	72	$0.00
D0603		245	235	$0.00