PROFESSONAL DENTAL ALLIANCE OF WORTHINGTON, LLC

NPI: 1356815401 · WORTHINGTON, OH 43085 · Dentist · NPI assigned 01/11/2019

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official QUINTEROS, ERICA controls 13+ related entities in our dataset. Read more

$27K

Total Medicaid Paid

381

Total Claims

342

Beneficiaries

Codes Billed

2024-07

First Month

2024-12

Last Month

Provider Details

Authorized Official	QUINTEROS, ERICA (CREDENTIALING ENROLLMENT MANAGER)
NPI Enumeration Date	01/11/2019

Other providers sharing the same authorized official: QUINTEROS, ERICA

Provider	City	State	Total Paid
PROFESSIONAL DENTAL ALLIANCE OF TENNESSEE, PLLC	CHATTANOOGA	TN	$11.49M
PROFESSIONAL DENTAL ALLIANCE OF CT - PEDO, PLLC	FAIRFIELD	CT	$2.05M
PROFESSIONAL DENTAL ALLIANCE OF BRIGHTON, PLLC	BRIGHTON	MI	$2.03M
PROFESSIONAL DENTAL ALLIANCE OF TAYLOR, PLLC	TAYLOR	MI	$1.18M
PROFESSIONAL DENTAL ALLIANCE OF FARMINGTON, PLLC	FARMINGTON	MI	$379K
PROFESSIONAL DENTAL ALLIANCE OF NORWALK, PLLC	NORWALK	CT	$323K
PROFESSIONAL DENTAL ALLIANCE OF MI - LMTD, PLLC	CHESTERFIELD	MI	$313K
PROFESSIONAL DENTAL ALLIANCE SPECIALTY, LLC	BOARDMAN	OH	$279K
PROFESSIONAL DENTAL ALLIANCE OF FLAT ROCK, PLLC	FLAT ROCK	MI	$240K
PROFESSIONAL DENTAL ALLIANCE OF FLORIDA, PLLC	PORT ST LUCIE	FL	$143K
PROFESSIONAL DENTAL ALLIANCE OF BURTON, PLLC	BURTON	MI	$132K
PROFESSIONAL DENTAL ALLIANCE OF CT - ORTHO, PLLC	FAIRFIELD	CT	$127K
PROFESSIONAL DENTAL ALLIANCE OF MERIDIAN, PLLC	CUMBERLAND	MD	$141.84

Year	Claims	Total Paid
2024	381	$27K

Code	Description	Claims	Beneficiaries	Total Paid
D0210	Intraoral - complete series of radiographic images	82	82	$9K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	71	36	$7K
D0150	Comprehensive oral evaluation - new or established patient	140	138	$7K
D2950		13	12	$2K
D0140	Limited oral evaluation - problem focused	35	35	$1K
D0220	Intraoral - periapical first radiographic image	40	39	$395.17