NE SPECIALTY DENTAL SERVICES LLC

NPI: 1356108393 · OMAHA, NE 68135 · Pediatric Dentist · NPI assigned 03/05/2024

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official DASCH, CHARLOTTE controls 20+ related entities in our dataset. Read more

$35K

Total Medicaid Paid

1,266

Total Claims

1,077

Beneficiaries

Codes Billed

2024-09

First Month

2024-12

Last Month

Provider Details

Authorized Official	DASCH, CHARLOTTE (DIRECTOR OF CRED AND PR)
Parent Organization	NE SPECIALTY DENTAL SERVICES LLC
NPI Enumeration Date	03/05/2024

Other providers sharing the same authorized official: DASCH, CHARLOTTE

Provider	City	State	Total Paid
UT BCDO SPECIALTY DENTAL SERVICES, PLLC	WEST JORDAN	UT	$14.06M
TN SPECIALTY DENTAL SERVICES, PLLC	BRENTWOOD	TN	$8.67M
CDPT II PC	DALLAS	TX	$3.16M
TN SPECIALTY DENTAL SERVICES, PLLC	KNOXVILLE	TN	$848K
NE SPECIALTY DENTAL SERVICES LLC	OMAHA	NE	$521K
MT OMS SPECIALTY DENTAL SERVICES, PLLC	BILLINGS	MT	$480K
CO SPECIALTY DENTAL SERVICES PLLC	AURORA	CO	$341K
CO SPECIALTY DENTAL SERVICES PLLC	GLENDALE	CO	$255K
UT SPECIALTY DENTAL SERVICES, PLLC	SPANISH FORK	UT	$166K
CO SPECIALTY DENTAL SERVICES PLLC	PARKER	CO	$120K
TN SPECIALTY DENTAL SERVICES, PLLC	BRENTWOOD	TN	$117K
TN SPECIALTY DENTAL SERVICES, PLLC	HENDERSONVILLE	TN	$98K
NE OMS SPECIALTY DENTAL SERVICES, LLC	OMAHA	NE	$57K
TN SPECIALTY DENTAL SERVICES, PLLC	NOLENSVILLE	TN	$54K
OK OMS SPECIALTY DENTAL SERVICES	OKLAHOMA CITY	OK	$38K
OK SPECIALTY DENTAL SERVICES PLLC	OKLAHOMA CITY	OK	$32K
CO SPECIALTY DENTAL SERVICES PLLC	THORNTON	CO	$23K
CO SPECIALTY DENTAL SERVICES PLLC	COLORADO SPRINGS	CO	$13K
CO SPECIALTY DENTAL SERVICES PLLC	COLORADO SPRINGS	CO	$5K
TN SPECIALTY DENTAL SERVICES, PLLC	BRENTWOOD	TN	$5K

Year	Claims	Total Paid
2024	1,266	$35K

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	313	296	$10K
D1206	Topical application of fluoride varnish	358	336	$9K
D0120	Periodic oral evaluation - established patient	315	297	$9K
D1351	Sealant - per tooth	151	26	$5K
D0272	Bitewings - two radiographic images	116	110	$2K
D1110	Prophylaxis - adult	13	12	$491.04