MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WINTER PARK, PA

NPI: 1306138045 · WINTER PARK, FL 32789 · Dentist · NPI assigned 05/13/2011

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$1.68M

Total Medicaid Paid

91,290

Total Claims

84,255

Beneficiaries

Codes Billed

2018-09

First Month

2024-12

Last Month

Provider Details

Authorized Official	GOMEZ, STEPHANIE (CREDENTIALING SUPERVISOR)
NPI Enumeration Date	05/13/2011

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 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	10,421	10,322	$505K
D1110	Prophylaxis - adult	3,288	3,256	$202K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2,648	1,778	$184K
D0330	Panoramic radiographic image	1,892	1,877	$141K
D0150	Comprehensive oral evaluation - new or established patient	3,058	3,018	$131K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	3,870	3,679	$96K
D0120	Periodic oral evaluation - established patient	10,542	10,429	$62K
D1351	Sealant - per tooth	5,708	1,511	$58K
D1208	Topical application of fluoride, excluding varnish	12,419	12,288	$40K
D2930	Prefabricated stainless steel crown - primary tooth	207	149	$34K
D0272	Bitewings - two radiographic images	6,404	6,339	$34K
D0220	Intraoral - periapical first radiographic image	6,368	6,221	$33K
D0274	Bitewings - four radiographic images	4,646	4,600	$30K
D0140	Limited oral evaluation - problem focused	890	857	$25K
D2391	Resin-based composite - one surface, posterior, primary or permanent	477	357	$24K
D1330		10,990	10,851	$24K
D7140	Extraction, erupted tooth or exposed root	479	353	$17K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	110	93	$14K
D0230	Intraoral - periapical each additional radiographic image	5,144	5,007	$9K
D7111		133	84	$8K
D3120		1,322	912	$4K
D9999	Unspecified adjunctive procedure, by report	146	146	$4K
D0999	Unspecified diagnostic procedure, by report	74	74	$1K
D0210	Intraoral - complete series of radiographic images	12	12	$1K
D1999		27	27	$1K
D1206	Topical application of fluoride varnish	15	15	$16.00