WEST INDY PIPPIN DENTAL PC

NPI: 1356816037 · INDIANAPOLIS, IN 46214 · Pediatric Dentist · NPI assigned 10/09/2018

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official MAYFIELD, DALE controls 20+ related entities in our dataset. Read more

$191K

Total Medicaid Paid

6,500

Total Claims

5,249

Beneficiaries

Codes Billed

2019-03

First Month

2020-08

Last Month

Provider Details

Authorized Official	MAYFIELD, DALE (PRESIDENT)
NPI Enumeration Date	10/09/2018

Other providers sharing the same authorized official: MAYFIELD, DALE

Provider	City	State	Total Paid
KS2 MS ,PC	BILOXI	MS	$16.22M
KS2 MS PC	HATTIESBURG	MS	$10.15M
47TH STREET DENTAL CENTER, LLC	KANSAS CITY	KS	$8.95M
KS2 MS, PC	JACKSON	MS	$8.50M
EAST 53RD STREET DENTAL-1, PC	INDIANAPOLIS	IN	$7.41M
EAST 29TH STREET DENTAL CENTER, LLC	TOPEKA	KS	$5.92M
GREAT PLAINS DENTAL GROUP, LLC	WICHITA	KS	$5.80M
NORTH MESA DENTAL, PC	LUBBOCK	TX	$4.47M
KS2 MS PC	JACKSON	MS	$4.11M
NORTH MESA DENTAL, PC	SHERMAN	TX	$3.99M
KS AZ-2, PC	TUCSON	AZ	$3.66M
NORTH MESA DENTAL, PC	LUFKIN	TX	$3.37M
KS2 MS PC	TUPELO	MS	$3.14M
NORTH MESA DENTAL, PC	LONGVIEW	TX	$3.11M
NORTH MESA DENTAL, PC	AMARILLO	TX	$2.93M
NORTH MESA DENTAL, PC	WICHITA FALLS	TX	$2.88M
NORTH MESA DENTAL, PC	SAN ANGELO	TX	$2.77M
NORTH MESA DENTAL, PC	LONGVIEW	TX	$2.27M
NORTH MESA DENTAL, PC	ODESSA	TX	$2.23M
KS AZ-2, PC	TUCSON	AZ	$2.13M

Year	Claims	Total Paid
2019	4,078	$125K
2020	2,422	$65K

Code	Description	Claims	Beneficiaries	Total Paid
D0150	Comprehensive oral evaluation - new or established patient	735	598	$24K
D1110	Prophylaxis - adult	483	420	$22K
D1120	Prophylaxis - child	687	591	$21K
D0210	Intraoral - complete series of radiographic images	397	356	$20K
D1206	Topical application of fluoride varnish	860	749	$17K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	225	140	$16K
D0120	Periodic oral evaluation - established patient	598	560	$13K
D0274	Bitewings - four radiographic images	411	358	$13K
D1351	Sealant - per tooth	293	54	$8K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	335	240	$8K
D0272	Bitewings - two radiographic images	391	337	$8K
D2391	Resin-based composite - one surface, posterior, primary or permanent	88	58	$5K
D0330	Panoramic radiographic image	190	138	$5K
D1208	Topical application of fluoride, excluding varnish	180	143	$3K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	23	12	$2K
D0140	Limited oral evaluation - problem focused	59	53	$2K
D0220	Intraoral - periapical first radiographic image	168	145	$2K
D0230	Intraoral - periapical each additional radiographic image	65	50	$478.00
D1999		312	247	$345.00