Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

GULFSIDE DENTAL

NPI: 1609132612 · BEAUMONT, TX 77706 · Dentist · NPI assigned 04/03/2012

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official PU, MARY controls 20+ related entities in our dataset. Read more

$939K
Total Medicaid Paid
43,729
Total Claims
31,254
Beneficiaries
17
Codes Billed
2020-11
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPU, MARY (VP OF FINANCE)
NPI Enumeration Date04/03/2012

Related Entities

Other providers sharing the same authorized official: PU, MARY

ProviderCityStateTotal Paid
RED ROCK DENTAL-FARMINGTON IRVING TX $3.59M
SAGE DENTAL BAYTOWN TX $2.35M
PEPPERMINT DENTAL-MONTGOMERY LLC ALBUQUERQUE NM $2.14M
SAGE DENTAL-DEER PARK PLLC LA PORTE TX $1.87M
VINH NGO DENTISTRY PLLC VICTORIA TX $1.65M
ELEMENT DENTAL-BRYAN PLLC BRYAN TX $1.57M
FUSION DENTAL IRVING TX $1.49M
ELEMENT DENTAL-CONROE PLLC IRVING TX $1.49M
GULFSIDE DENTAL PORT ARTHUR PLLC PORT ARTHUR TX $1.39M
PEPPERMINT DENTAL-RIO BRAVO LLC ALBUQUERQUE NM $1.29M
FRESH DENTAL-SHREVEPORT IRVING TX $1.27M
FRESH DENTAL-BOSSIER CITY IRVING TX $1.21M
PEPPERMINT DENTAL-SHERMAN PLLC SHERMAN TX $1.17M
ELEMENT DENTAL PLLC LUFKIN TX $1.06M
RIO DENTAL AND ORTHODONTICS LLC RIO RANCHO NM $1.00M
ELEMENT DENTAL-HUMBLE PLLC HUMBLE TX $942K
LEGEND DENTAL-GEORGETOWN GEORGETOWN TX $919K
BLISS DENTAL PLLC ODESSA TX $827K
BLISS DENTAL LUBBOCK PLLC LUBBOCK TX $826K
ARCHSTONE DENTAL-GRANBURY PLLC GRANBURY TX $817K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 1,658 $34K
2021 10,396 $253K
2022 10,811 $239K
2023 12,502 $245K
2024 8,362 $168K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 4,110 3,945 $138K
D1351 Sealant - per tooth 5,145 814 $133K
D1110 Prophylaxis - adult 2,187 2,106 $106K
D0230 Intraoral - periapical each additional radiographic image 9,198 2,447 $94K
D0120 Periodic oral evaluation - established patient 3,325 3,144 $86K
D0145 Oral evaluation for a patient under three years of age 554 543 $72K
D0274 Bitewings - four radiographic images 2,253 2,175 $71K
D1206 Topical application of fluoride varnish 4,651 4,463 $62K
D0210 Intraoral - complete series of radiographic images 846 796 $51K
D0220 Intraoral - periapical first radiographic image 2,729 2,623 $31K
D0150 Comprehensive oral evaluation - new or established patient 1,064 977 $31K
D2930 Prefabricated stainless steel crown - primary tooth 202 90 $26K
D1208 Topical application of fluoride, excluding varnish 1,383 1,341 $19K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 169 63 $16K
D2391 Resin-based composite - one surface, posterior, primary or permanent 58 25 $5K
D0603 5,842 5,689 $0.03
D0602 13 13 $0.00