MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CAPE CORAL, P.A.

NPI: 1740557198 · CAPE CORAL, FL 33914 · Dentist · NPI assigned 11/29/2011

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official GOMEZ, STEPHANIE controls 20+ related entities in our dataset. Read more

$2.21M

Total Medicaid Paid

80,821

Total Claims

72,960

Beneficiaries

Codes Billed

2018-09

First Month

2024-12

Last Month

Provider Details

Authorized Official	GOMEZ, STEPHANIE (PROVIDER RELATIONS SPECIALIST)
NPI Enumeration Date	11/29/2011

Related Entities

Other providers sharing the same authorized official: GOMEZ, STEPHANIE

Provider	City	State	Total Paid
DENTISTRY FOR CHILDREN PC	YONKERS	NY	$4.59M
MAIN STREET CHILDREN'S DENTISTRY OF MIAMI LAKES, PLLC	MIAMI LAKES	FL	$2.59M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CLERMONT, PLLC	CLERMONT	FL	$2.38M
DENTAL CENTER AT FOREST HILL, PA	WEST PALM BEACH	FL	$2.29M
MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF PALMETTO BAY, PA	PALMETTO BAY	FL	$2.22M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF HOMESTEAD, P.A.	HOMESTEAD	FL	$2.10M
MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS WATERFORD LAKES PLLC	ORLANDO	FL	$1.82M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF FT. MYERS, P.A.	FORT MYERS	FL	$1.80M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WINTER PARK, PA	WINTER PARK	FL	$1.68M
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY, P.A.	ORANGE CITY	FL	$1.58M
DENTAL SPECIALTY CENTER OF FT. MYERS, PA	FORT MYERS	FL	$1.40M
PALM DENTAL CENTER, PA	HIALEAH	FL	$1.27M
MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF NAPLES, PA	NAPLES	FL	$1.16M
MAIN STREET CHILDREN'S DENTISTRY OF AVENTURA, PA	AVENTURA	FL	$1.06M
TDG DENTAL GROUP PLLC	WOODBRIDGE	VA	$1.01M
DENTAL CENTER AT BAPTIST, PA	MIAMI	FL	$851K
SUNRISE DENTAL GROUP P.A.	PLANTATION	FL	$833K
MAIN STREET CHILDREN'S DENTISTRY OF JUPITER, PA	JUPITER	FL	$824K
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF SOUTH BROWARD, PA	COOPER CITY	FL	$717K
CHILDREN'S DENTAL CENTER OF KENDALL, PA	MIAMI	FL	$601K

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2018	1,509	$45K
2019	216	$8K
2020	6,980	$190K
2021	6,452	$147K
2022	24,146	$542K
2023	24,152	$776K
2024	17,366	$502K

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	10,333	10,224	$505K
D9243		418	351	$237K
D1110	Prophylaxis - adult	3,033	2,995	$205K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2,005	1,501	$160K
D3330	Endodontic therapy, molar tooth (excluding final restoration)	205	143	$157K
D0140	Limited oral evaluation - problem focused	2,516	2,415	$140K
D0150	Comprehensive oral evaluation - new or established patient	2,541	2,519	$133K
D0330	Panoramic radiographic image	1,858	1,840	$110K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	3,612	3,427	$80K
D7240	Removal of impacted tooth - completely bony	485	181	$61K
D1208	Topical application of fluoride, excluding varnish	12,028	11,911	$59K
D0120	Periodic oral evaluation - established patient	10,753	10,639	$59K
D1351	Sealant - per tooth	6,040	1,782	$56K
D7140	Extraction, erupted tooth or exposed root	1,076	743	$55K
D2391	Resin-based composite - one surface, posterior, primary or permanent	735	607	$38K
D0272	Bitewings - two radiographic images	4,675	4,605	$30K
D1330		4,740	4,630	$23K
D0220	Intraoral - periapical first radiographic image	4,370	4,185	$19K
D9239		374	349	$18K
D2930	Prefabricated stainless steel crown - primary tooth	102	91	$18K
D0274	Bitewings - four radiographic images	3,588	3,558	$17K
D1354		715	277	$14K
D9999	Unspecified adjunctive procedure, by report	284	284	$6K
D0230	Intraoral - periapical each additional radiographic image	2,652	2,517	$4K
D3120		292	201	$2K
D1999		41	41	$2K
D0999	Unspecified diagnostic procedure, by report	78	78	$2K
D0240		187	126	$1K
D7921		476	245	$0.00
D9612		344	329	$0.00
D2950		265	166	$0.00