TDG DENTAL GROUP PLLC

NPI: 1992274153 · WOODBRIDGE, VA 22192 · General Practice Dentistry · NPI assigned 11/16/2018

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$1.01M

Total Medicaid Paid

44,731

Total Claims

40,224

Beneficiaries

Codes Billed

2019-01

First Month

2024-09

Last Month

Provider Details

Authorized Official	GOMEZ, STEPHANIE (CREDENTIALING SUPERVISOR)
NPI Enumeration Date	11/16/2018

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 CAPE CORAL, P.A.	CAPE CORAL	FL	$2.21M
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
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

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	5,308	5,145	$199K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1,099	624	$99K
D9630		5,581	5,499	$83K
D0274	Bitewings - four radiographic images	3,605	3,495	$81K
D0120	Periodic oral evaluation - established patient	5,213	5,117	$79K
D1208	Topical application of fluoride, excluding varnish	2,988	2,950	$56K
D0220	Intraoral - periapical first radiographic image	6,622	5,614	$55K
D0150	Comprehensive oral evaluation - new or established patient	2,031	1,686	$53K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	445	291	$52K
D2740	Crown - porcelain/ceramic	86	61	$43K
D0330	Panoramic radiographic image	1,241	807	$43K
D0140	Limited oral evaluation - problem focused	1,832	1,525	$39K
D0230	Intraoral - periapical each additional radiographic image	3,636	2,878	$31K
D1120	Prophylaxis - child	861	844	$26K
D0210	Intraoral - complete series of radiographic images	922	630	$26K
D2950		165	117	$19K
D9994		2,743	2,681	$10K
D2391	Resin-based composite - one surface, posterior, primary or permanent	155	89	$9K
D9310		67	41	$3K
D4355		13	13	$991.36
D0272	Bitewings - two radiographic images	41	40	$952.75
D8670	Periodic orthodontic treatment visit	12	12	$0.00
D4910		65	65	$0.00