Dental
Kyle Pediatric Dental
Kyle Pediatric Dental was paid $352K by Medicaid between Nov 2020 and Jun 2021, across 21 billing codes. Its largest line is D1351, Sealant - per tooth — 15% of everything it billed.
33Billing provider infoKYLE PEDIATRIC DENTAL
KYLE, TX 78640
KYLE, TX 78640
33aNPI1679975932assigned 09/18/2014
33bProvider typePediatric Dentist
28Total paid$352K
24GClaims15,501
24DCodes billed21
24AFirst – last monthNov 2020 – Jun 2021
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#310 of 693
Median peer was paid$252K
This provider vs. median1.4×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MONTGOMERY, MARTY controls 11+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 3,246 | $76K | |
| 2021 | 12,255 | $276K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 15% | 1,987 | 491 | $54K |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 1,280 | 1,265 | $46K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 1,462 | 1,448 | $41K |
| D0145 | Oral evaluation for a patient under three years of age | 12% | 291 | 289 | $41K |
| D1208 | Topical application of fluoride, excluding varnish | 6.7% | 1,653 | 1,635 | $24K |
| D0272 | Bitewings - two radiographic images | 6.2% | 1,039 | 1,026 | $22K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.1% | 2,132 | 1,695 | $21K |
| D0220 | Intraoral - periapical first radiographic image | 5.7% | 1,803 | 1,774 | $20K |
| D1110 | Prophylaxis - adult | 5.0% | 335 | 331 | $18K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.2% | 198 | 119 | $15K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.2% | 157 | 91 | $15K |
| D0274 | Bitewings - four radiographic images | 2.8% | 330 | 326 | $10K |
9 more codes
| D9248 | 1.7% | 59 | $6K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.5% | 155 | $5K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.5% | 196 | $5K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.2% | 28 | $4K |
| D0330 | Panoramic radiographic image | <1% | 216 | $3K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 27 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 12 | $225.36 |
| D1206 | Topical application of fluoride varnish | <1% | 12 | $160.23 |
| D0603 | 0% | 2,129 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMONTGOMERY, MARTY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| North Austin Pediatric Dental, PLLC | Austin, TX | $874K |
| Lone Star Pediatric Dental, PLLC | Austin, TX | $746K |
| Elgin Pediatric Dental PLLC | Elgin, TX | $397K |
| 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 |
| Children's Dental Ranch of New Braunfels, PLLC | New Braunfels, TX | $22K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.