ATLANTIC TERMINAL DENTAL, P.C.

NPI: 1760699870 · BROOKLYN, NY 11217 · General Practice Dentistry · NPI assigned 05/17/2007

$81K

Total Medicaid Paid

13,720

Total Claims

13,708

Beneficiaries

Codes Billed

2018-01

First Month

2024-11

Last Month

Provider Details

Authorized Official	KRASNOV, ROSS (OWNER)
NPI Enumeration Date	05/17/2007

Other providers sharing the same authorized official: KRASNOV, ROSS

Provider	City	State	Total Paid
BRASS MILL MALL DENTAL L.L.P	WATERBURY	CT	$1.26M
TOWN CENTER DENTAL OF STAMFORD P.C.	STAMFORD	CT	$554K
STATEN ISLAND MALL DENTAL, P.C.	STATEN ISLAND	NY	$289K
HUDSON VALLEY PLAZA DENTAL LLP	TROY	NY	$278K
HUDSON VALLEY MALL DENTAL LLP	KINGSTON	NY	$132K
42ND STREET DENTAL, ASSOCIATES	NEW YORK	NY	$112K
GALLERIA MALL DENTAL PC	WHITE PLAINS	NY	$72K
PALISADES MALL DENTAL LLP	WEST NYACK	NY	$55K
OAKDALE MALL DENTAL LLP	JOHNSON CITY	NY	$40K
GALLERIA MALL DENTAL PC	MIDDLETOWN	NY	$27K

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	2,317	2,316	$32K
D0120	Periodic oral evaluation - established patient	3,099	3,099	$21K
D0220	Intraoral - periapical first radiographic image	3,848	3,840	$12K
D0274	Bitewings - four radiographic images	1,207	1,207	$8K
D0230	Intraoral - periapical each additional radiographic image	2,331	2,330	$4K
D0140	Limited oral evaluation - problem focused	289	287	$1K
D1120	Prophylaxis - child	144	144	$1K
D1208	Topical application of fluoride, excluding varnish	304	304	$821.47
D0272	Bitewings - two radiographic images	181	181	$598.73