CHILDREN'S DENTAL RANCH OF NEW BRAUNFELS, PLLC

NPI: 1558997734 · NEW BRAUNFELS, TX 78130 · Pediatric Dentist · NPI assigned 03/19/2020

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official MONTGOMERY, MARTY controls 11+ related entities in our dataset. Read more

$22K

Total Medicaid Paid

1,166

Total Claims

750

Beneficiaries

Codes Billed

2020-12

First Month

2021-06

Last Month

Provider Details

Authorized Official	MONTGOMERY, MARTY (OWNER/DOCTOR)
NPI Enumeration Date	03/19/2020

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 COVE PLLC	COPPERAS COVE	TX	$106K
LSPD AT CIRCLE C, PLLC	AUSTIN	TX	$69K
DRIPPING SPRINGS PEDIATRIC DENTAL, PLLC	DRIPPING SPRINGS	TX	$28K

Year	Claims	Total Paid
2020	72	$840.15
2021	1,094	$21K

Code	Description	Claims	Beneficiaries	Total Paid
D1351	Sealant - per tooth	448	71	$12K
D0150	Comprehensive oral evaluation - new or established patient	81	78	$2K
D0145	Oral evaluation for a patient under three years of age	12	12	$2K
D1120	Prophylaxis - child	43	41	$1K
D1208	Topical application of fluoride, excluding varnish	85	82	$1K
D0220	Intraoral - periapical first radiographic image	107	104	$862.54
D0272	Bitewings - two radiographic images	50	47	$809.39
D0330	Panoramic radiographic image	33	30	$742.11
D0230	Intraoral - periapical each additional radiographic image	107	87	$698.66
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	15	13	$404.57
D0603		185	185	$0.00