NPI: 1336604867 · COPPERAS COVE, TX 76522 · General Practice Dentistry · NPI assigned 02/08/2019
Authorized official MONTGOMERY, MARTY controls 11+ related entities in our dataset. Read more
| Authorized Official | MONTGOMERY, MARTY (DMD/OWNER) |
| NPI Enumeration Date | 02/08/2019 |
Other providers sharing the same authorized official: MONTGOMERY, MARTY
| Provider | City | State | Total Paid |
|---|---|---|---|
| NORTH AUSTIN PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $874K |
| LONE STAR PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $746K |
| ELGIN PEDIATRIC DENTAL PLLC | ELGIN | TX | $397K |
| KYLE PEDIATRIC DENTAL | KYLE | TX | $352K |
| LSPD AT KILLEEN, PLLC | KILLEEN | TX | $259K |
| T & S OMFS PLLC | AUSTIN | TX | $188K |
| LAKEWAY PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $134K |
| CENTRAL AUSTIN PEDIATRIC DENTAL, PLLC | AUSTIN | TX | $122K |
| LSPD AT CIRCLE C, PLLC | AUSTIN | TX | $69K |
| DRIPPING SPRINGS PEDIATRIC DENTAL, PLLC | DRIPPING SPRINGS | TX | $28K |
| CHILDREN'S DENTAL RANCH OF NEW BRAUNFELS, PLLC | NEW BRAUNFELS | TX | $22K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 938 | $22K |
| 2021 | 3,976 | $83K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 896 | 183 | $24K |
| D0145 | Oral evaluation for a patient under three years of age | 169 | 166 | $23K |
| D1120 | Prophylaxis - child | 407 | 402 | $14K |
| D0120 | Periodic oral evaluation - established patient | 324 | 319 | $9K |
| D0272 | Bitewings - two radiographic images | 370 | 366 | $7K |
| D1208 | Topical application of fluoride, excluding varnish | 471 | 464 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 576 | 563 | $6K |
| D0230 | Intraoral - periapical each additional radiographic image | 639 | 533 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 138 | 134 | $5K |
| D1110 | Prophylaxis - adult | 45 | 44 | $2K |
| D0330 | Panoramic radiographic image | 81 | 80 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 16 | 12 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 35 | 29 | $911.34 |
| D0274 | Bitewings - four radiographic images | 35 | 34 | $816.29 |
| D0603 | 712 | 704 | $0.00 |