SD PARK ROW PLLC

NPI: 1619666898 · ARLINGTON, TX 76013 · General Practice Dentistry · NPI assigned 05/03/2023

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official PHAM, LYNHTHY controls 20+ related entities in our dataset. Read more

$6K

Total Medicaid Paid

364

Total Claims

301

Beneficiaries

Codes Billed

2023-12

First Month

2024-11

Last Month

Provider Details

Authorized Official	PHAM, LYNHTHY (OWNER)
NPI Enumeration Date	05/03/2023

Other providers sharing the same authorized official: PHAM, LYNHTHY

Provider	City	State	Total Paid
SD GREENVILLE LLC	GREENVILLE	TX	$719K
SD CORPUS CHRISTI PLLC	CORPUS CHRISTI	TX	$557K
SD- ROOSEVELT PC	SAN ANTONIO	TX	$314K
SD TEXARKANA	TEXARKANA	TX	$280K
SD- 4315FREDERICK PC	SAN ANTONIO	TX	$218K
SMILEY DENTAL SINGLETON PLLC	DALLAS	TX	$215K
SD- POTRANCO, PC	SAN ANTONIO	TX	$178K
SMILEY DENTAL - UNIVERSITY	DENTON	TX	$114K
SMILEY DENTAL MCCART PLLC	FORT WORTH	TX	$55K
SMILEY DENTAL KEMP PLLC	WICHITA FALLS	TX	$47K
SD MEADOWBROOK PLLC	FORT WORTH	TX	$26K
SD-BRAUN, PC	SAN ANTONIO	TX	$22K
SD-933SCHERTZ PC	SCHERTZ	TX	$22K
SD-HWY 78 PC	SAN ANTONIO	TX	$20K
SD-DEZAVALA PC	SAN ANTONIO	TX	$15K
SMILEY DENTAL LAMAR PLLC	AUSTIN	TX	$12K
SD SAGINAW PLLC	SAGINAW	TX	$8K
SD HALTOM CITY PLLC	HALTOM CITY	TX	$4K
SD VALLEY MILLS PLLC	WACO	TX	$3K
SD PARK LAKE PLLC	WACO	TX	$2K

Year	Claims	Total Paid
2023	14	$494.48
2024	350	$5K

Code	Description	Claims	Beneficiaries	Total Paid
D0150	Comprehensive oral evaluation - new or established patient	84	83	$3K
D0230	Intraoral - periapical each additional radiographic image	107	52	$1K
D0220	Intraoral - periapical first radiographic image	86	83	$932.80
D1120	Prophylaxis - child	16	15	$543.91
D1208	Topical application of fluoride, excluding varnish	32	31	$452.76
D0603		39	37	$9.01