GROESBECK FAMILY DENTAL

NPI: 1710540232 · GROESBECK, TX 76642 · Dental Clinic/Center · NPI assigned 04/19/2019

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official JENNINGS, WILLIAM controls 11+ related entities in our dataset. Read more

$4K

Total Medicaid Paid

254

Total Claims

204

Beneficiaries

Codes Billed

2020-12

First Month

2021-03

Last Month

Provider Details

Authorized Official	JENNINGS, WILLIAM (OWNER)
NPI Enumeration Date	04/19/2019

Other providers sharing the same authorized official: JENNINGS, WILLIAM

Provider	City	State	Total Paid
MARIETTA FAMILY DENTISTRY	MARIETTA	OK	$299K
MARSHALL FAMILY DENTAL PLLC	MARSHALL	TX	$124K
SMILELAND FAMILY DENTAL	SAN ANTONIO	TX	$118K
ARDMORE FAMILY DENTISTRY	ARDMORE	OK	$112K
WACO FAMILY DENTAL PLLC	BELLMEAD	TX	$71K
BROADWAY FAMILY DENTAL PLLC	GALVESTON	TX	$37K
MADILL FAMILY DENTISTRY PLLC	MADILL	OK	$8K
CLEAR CREEK FAMILY DENTAL	HARKER HEIGHTS	TX	$7K
ROBBY JENNINGS DENTAL	TYLER	TX	$4K
HEWITT FAMILY DENTAL	WOODWAY	TX	$4K
LOCHWOOD FAMILY DENTAL PLLC	DALLAS	TX	$0.00

Year	Claims	Total Paid
2020	61	$848.63
2021	193	$3K

Code	Description	Claims	Beneficiaries	Total Paid
D0150	Comprehensive oral evaluation - new or established patient	35	28	$900.67
D1110	Prophylaxis - adult	13	13	$647.58
D1120	Prophylaxis - child	21	14	$514.50
D0274	Bitewings - four radiographic images	23	17	$470.70
D0120	Periodic oral evaluation - established patient	13	12	$337.62
D0272	Bitewings - two radiographic images	20	13	$303.94
D1208	Topical application of fluoride, excluding varnish	21	14	$205.80
D0220	Intraoral - periapical first radiographic image	21	14	$175.84
D0230	Intraoral - periapical each additional radiographic image	20	13	$149.63
D0602		67	66	$0.00