MORTENSON FAMILY DENTAL CENTER-SHELBYVILLE EAST

NPI: 1801109053 · SHELBYVILLE, KY 40065 · Clinic/Center · NPI assigned 07/16/2010

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official JAMES, STEVE controls 20+ related entities in our dataset. Read more

$443K

Total Medicaid Paid

5,412

Total Claims

4,509

Beneficiaries

Codes Billed

2022-08

First Month

2024-11

Last Month

Provider Details

Authorized Official	JAMES, STEVE (CFO)
NPI Enumeration Date	07/16/2010

Other providers sharing the same authorized official: JAMES, STEVE

Provider	City	State	Total Paid
KIDS DENTISTRY-JEFFERSON MALL,PLLC	LOUISVILLE	KY	$9.77M
KIDS DENTISTRY-JEFFERSONVILLE, LLC	JEFFERSONVILLE	IN	$6.37M
KIDS DENTISTRY-NEW ALBANY	NEW ALBANY	IN	$4.61M
KIDS DENTISTREE - WESTPORT VILLAGE	LOUISVILLE	KY	$4.19M
MORTENSON FAMILY DENTAL CENTER-VALLEY STATION	LOUISVILLE	KY	$3.06M
ORAL SURGERY GROUP OF SOUTHERN INDIANA, LLC	NEW ALBANY	IN	$1.99M
SUMMIT DENTAL HEALTH - E STREET LLC	OMAHA	NE	$1.99M
SUMMIT DENTAL HEALTH - BRENTWOOD LLC	LA VISTA	NE	$1.79M
MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, PLLC	LOUISVILLE	KY	$1.77M
SUMMIT DENTAL HEALTH - DUNDEE LLC	OMAHA	NE	$1.71M
SUMMIT DENTAL HEALTH - TOWNE LLC	BELLEVUE	NE	$1.60M
SUMMIT DENTAL HEALTH - CENTER LLC	OMAHA	NE	$1.28M
SUMMIT DENTAL HEALTH - OAKVIEW, LLC	OMAHA	NE	$1.21M
MORTENSON FAMILY DENTAL CENTER	LOUISVILLE	KY	$1.10M
MORTENSON FAMILY DENTAL CENTER - VERSAILLES, PLLC	VERSAILLES	KY	$793K
MORTENSON FAMILY DENTAL CENTER	CRESTWOOD	KY	$631K
MORTENSONFAMILYDENTALCENTER-BUECHEL, PLLC	LOUISVILLE	KY	$554K
MORTENSON FAMILY DENTAL CENTER - ELIZABETHTOWN NORTH, PLLC	ELIZABETHTOWN	KY	$546K
SUMMIT DENTAL HEALTH - OLD MARKET LLC	OMAHA	NE	$543K
CHILDREN'S DENTAL CENTER OF BIG SPRING, PLLC	BIG SPRING	TX	$481K

Code	Description	Claims	Beneficiaries	Total Paid
D2740	Crown - porcelain/ceramic	327	192	$183K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	817	414	$58K
D0210	Intraoral - complete series of radiographic images	630	590	$48K
D0150	Comprehensive oral evaluation - new or established patient	1,082	1,063	$40K
D1110	Prophylaxis - adult	438	420	$25K
D2950		188	125	$20K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	170	106	$14K
D0140	Limited oral evaluation - problem focused	258	246	$11K
D2391	Resin-based composite - one surface, posterior, primary or permanent	178	105	$10K
D0120	Periodic oral evaluation - established patient	281	266	$9K
D0330	Panoramic radiographic image	110	109	$8K
D0220	Intraoral - periapical first radiographic image	577	554	$7K
D1206	Topical application of fluoride varnish	177	171	$4K
D0274	Bitewings - four radiographic images	100	95	$3K
D1120	Prophylaxis - child	25	25	$2K
D0230	Intraoral - periapical each additional radiographic image	54	28	$363.09