WILLOWBROOK MALL DENTAL

NPI: 1316287717 · HOUSTON, TX 77070 · General Practice Dentistry · NPI assigned 02/21/2013

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$10K

Total Medicaid Paid

1,084

Total Claims

1,039

Beneficiaries

Codes Billed

2020-12

First Month

2023-12

Last Month

Provider Details

Authorized Official	KRASNOV, ROSTISLAV (OWNER)
NPI Enumeration Date	02/21/2013

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
METROTECH DENTAL ASSOCIATES PLLC	BROOKLYN	NY	$8K
WHEATON MALL DENTAL LLP	WHEATON	MD	$3K
PG PLAZE DENTAL	HYATTSVILLE	MD	$3K

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	91	89	$2K
D0120	Periodic oral evaluation - established patient	93	90	$2K
D1208	Topical application of fluoride, excluding varnish	132	129	$1K
D0220	Intraoral - periapical first radiographic image	201	189	$1K
D0230	Intraoral - periapical each additional radiographic image	169	160	$1K
D0274	Bitewings - four radiographic images	49	46	$761.42
D1110	Prophylaxis - adult	27	24	$493.92
D0150	Comprehensive oral evaluation - new or established patient	29	28	$211.92
D1330		42	40	$12.25
D0603		251	244	$0.01