Attachment_B-Top_Dentist_List.xlsx
XLSX spreadsheet 19 KB Posted
- Attached to
- Group Dental Plan State and local contract opportunity
- Solicitation number
- 048-PLA-0515
- Issued by
- Polk County, Florida
About this file
This is an attachment listing for a Group Dental Plan Request for Proposal (RFP #048-PLA-0515) issued by the School Board of Polk County, Florida. The document serves as a "Top Dentist List" that identifies dental providers currently contracted within the school board's PPO network. Bidders responding to this RFP are required to complete this attachment by marking an "X" in the yellow highlighted column next to each provider they have contracted in their PPO network, and to note any dentists excluded from any of the three PPO plan options. The completed form must be submitted with proposals in both hard copy and Excel format as specified in the Request for Proposal documentation.
The attachment lists 139 dental providers across Polk County, Florida, organized by license number, specialty, name, address, and geographic location. The providers include general dentists, pediatric dentists, endodontists, oral surgeons, periodontists, and prosthodontists, with historical claimant and claims data provided for reference. The list identifies which providers have generated the highest utilization, with the top providers including Billy B Brown Jr. (380 claimants, 2,237 claims), Thomas F Plunkett (331 claimants, 2,202 claims), and Harry Bopp (327 claimants, 2,418 claims). This data enables the School Board of Polk County to evaluate bidders' proposed networks against existing provider utilization patterns and ensure continuity of care for plan members.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 048-PLA-0515_Renewal_for_2021_and_2022.pdf | ||
| RFP_048-PLA-0515_Board_Approval_Renewal_2019-2020.pdf | ||
| 048-PLA-0515_Renewal_RFP-Group_Dental_Plan_2018-2020_.pdf | ||
| Attachment_D-Certificate_of_Coverage.pdf | ||
| NRBA_048-PLA-0515.pdf | ||
| Attachment_A-RFP_Proposal_Worksheet_REVISED.docx | DOCX document | |
| Attachment_A-_RFP_Proposal_Worksheet.docx | DOCX document | |
| Attachment_B-Top_Dentist_List_REVISED.xlsx | XLSX spreadsheet | |
| Attachment_E-Census.xlsx | XLSX spreadsheet | |
| Attachment_F-Dental_Claims_Experience_.zip | ZIP file | |
| 048-PLA-0515_RFP-Group_Dental_Plan_.pdf | ||
| Addendum_01.pdf | ||
| Attachment_C-_Top_Dental_Procedures.xlsx | XLSX spreadsheet | |
| Attachment_G-Updated_Experience_Report.xlsx | XLSX spreadsheet | |
| Addendum_02.pdf | ||
| Award_048-PLA-0515.pdf |
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Text version
ProvUtil
| School Board of Polk County |
| Group Dental Plan, RFP #048-PLA-0515 |
| ATTACHMENT B - TOP DENTIST LIST |
| INSTRUCTIONS: In the yellow highlighted column please place an "X" next to each provider contracted in your PPO network. Please note if a dentist is excluded from any of the three PPO plan options. This form must be completed in full and submitted with your proposal in hard copy and in Excel format as specified in the Request for Proposal. |
| LICENSE | SPECIALTY | NAME | ADDRESS | CITY | STATE | ZIP | CLAIMANTS | CLAIMS | In-network |
| 000007209FL | GENERAL DENTIST | BILLY B BROWN JR | 695 S BROADWAY AVE | BARTOW | FL | 33830 | 380 | 2237 | |
| 000012385FL | GENERAL DENTIST | THOMAS F PLUNKETT | 200 LAKE HARRIS DR | LAKELAND | FL | 33813 | 331 | 2202 | |
| 000005979FL | PEDIATRIC DENTIST | HARRY BOPP | 1111 N PARKWAY FRONTAGE RD | LAKELAND | FL | 33803 | 327 | 2418 | |
| 000009526FL | GENERAL DENTIST | PHILLIP E ABBOTT | 780 E MAIN ST | BARTOW | FL | 33830 | 273 | 1398 | |
| 000013636FL | GENERAL DENTIST | ROBERT M PRISBE | 3835 S FLORIDA AVE | LAKELAND | FL | 33813 | 234 | 1527 | |
| 000011387FL | GENERAL DENTIST | JAMES A TRUITT | 144 AVENUE B NW | WINTER HAVEN | FL | 33881 | 221 | 988 | |
| 000010569FL | GENERAL DENTIST | LINDA J MAY | 1495 E MAIN ST | BARTOW | FL | 33830 | 212 | 1397 | |
| 000015466FL | GENERAL DENTIST | JAMIE W ODOM | 361 E CENTRAL AVE | WINTER HAVEN | FL | 33880 | 201 | 1002 | |
| 000010739FL | GENERAL DENTIST | SIUHUNG H FAN | 211 E LIME ST | LAKELAND | FL | 33801 | 201 | 806 | |
| 000017361FL | GENERAL DENTIST | PATRICK MICHAEL FERRY | 715 S BROADWAY AVE | BARTOW | FL | 33830 | 185 | 957 | |
| 000007033FL | GENERAL DENTIST | CRAIG W VALENTINE | 310 E HIGHLAND DR | LAKELAND | FL | 33813 | 166 | 620 | |
| 000008379FL | GENERAL DENTIST | GLENN R SHEUMAKER JR | 6731 US HIGHWAY 98 N | LAKELAND | FL | 33809 | 165 | 865 | |
| 000017195FL | PEDIATRIC DENTIST | EDWARD JORDAN TARVER | 1111 N PARKWAY FRONTAGE RD | LAKELAND | FL | 33803 | 162 | 1205 | |
| 000008327FL | GENERAL DENTIST | BRADLEY W BARTEL | 150 AVENUE A SE | WINTER HAVEN | FL | 33880 | 161 | 774 | |
| 000011515FL | PEDIATRIC DENTIST | KENNETH BENJAMINE ROGERS | 1550 1ST ST S | WINTER HAVEN | FL | 33880 | 158 | 942 | |
| 000011131FL | GENERAL DENTIST | BELKIS Z JONES | 5406 STRICKLAND AVE | LAKELAND | FL | 33812 | 157 | 827 | |
| 000013488FL | GENERAL DENTIST | STEVEN CIARAVINO | 294 PATTERSON RD | HAINES CITY | FL | 33844 | 148 | 732 | |
| 000014392FL | GENERAL DENTIST | STEPHEN J WALDING III | 3615 S FLORIDA AVE STE 850 | LAKELAND | FL | 33803 | 141 | 1187 | |
| 000007428FL | GENERAL DENTIST | GARY L JOYNER | 2025 FLAMINGO DR | BARTOW | FL | 33830 | 140 | 614 | |
| 000018565FL | GENERAL DENTIST | DIANA K CRAFT | 310 E HIGHLAND DR | LAKELAND | FL | 33813 | 138 | 727 | |
| 000018925FL | PEDIATRIC DENTIST | TIFFANY YI-TING CHEN | 1550 1ST ST S | WINTER HAVEN | FL | 33880 | 137 | 937 | |
| 000015580FL | GENERAL DENTIST | WILLIAM NERESTANT | 607 S MISSOURI AVE | LAKELAND | FL | 33815 | 132 | 834 | |
| 000018375FL | GENERAL DENTIST | NHUNG THANH NONG | 5535 CYPRESS GARDENS BLVD STE 120 | WINTER HAVEN | FL | 33884 | 131 | 754 | |
| 000016935FL | ENDODONTIST | HAIDER ALZUBAIDI | 3003 S FLORIDA AVE STE 101 | LAKELAND | FL | 33803 | 128 | 603 | |
| 000006787FL | GENERAL DENTIST | THOMAS A FELLNER | 24174 HWY 27 STE 200 | LAKE WALES | FL | 33859 | 125 | 780 | |
| 000019011FL | PEDIATRIC DENTIST | ERIN SMITH BERLING | 5710 US HIGHWAY 98 N | LAKELAND | FL | 33809 | 123 | 1194 | |
| 000006080FL | GENERAL DENTIST | KENNETH L MUNDY | 4326 HIGHLAND PARK BLVD | LAKELAND | FL | 33813 | 121 | 557 | |
| 000018539FL | ORAL SURGEON | JOSE LUIS LEON RAMIREZ | 400 AVENUE K SE STE 14A | WINTER HAVEN | FL | 33880 | 120 | 405 | |
| 000012653FL | PERIODONTIST | JEFFRY D BARNES | 320 AVENUE K SE STE 1 | WINTER HAVEN | FL | 33880 | 119 | 355 | |
| 000013330FL | GENERAL DENTIST | FARID MOGHADASI | 5608 US HIGHWAY 98 N | LAKELAND | FL | 33809 | 119 | 471 | |
| 000014269FL | PERIODONTIST | DAVID A CAMPBELL | 3003 S FLORIDA AVE STE 201 | LAKELAND | FL | 33803 | 118 | 367 | |
| 000012434FL | PEDIATRIC DENTIST | SHIRIN YASREBI | 2015 E EDGEWOOD DR | LAKELAND | FL | 33803 | 114 | 906 | |
| 000014558FL | GENERAL DENTIST | LEA D WHEELER | 4406 S FLORIDA AVE STE 29 | LAKELAND | FL | 33813 | 110 | 579 | |
| 000008002FL | GENERAL DENTIST | CHARLES R FORT | 330 E BROADWAY ST | FORT MEADE | FL | 33841 | 110 | 509 | |
| 000007070FL | GENERAL DENTIST | WILLIAM F CARDMAN | 4455 FLORIDA NATIONAL DR | LAKELAND | FL | 33813 | 107 | 693 | |
| 000015138FL | GENERAL DENTIST | ERIC L EBUEN | 4204 US HIGHWAY 98 N | LAKELAND | FL | 33809 | 105 | 900 | |
| 000017859FL | GENERAL DENTIST | JENNIFER O MARINO | 1375 TOWN CENTER DR | LAKELAND | FL | 33803 | 103 | 927 | |
| 000010646FL | GENERAL DENTIST | JENNIFER M STIDHAM | 620 E DAVIDSON ST | BARTOW | FL | 33830 | 102 | 574 | |
| 000008151FL | GENERAL DENTIST | JOHN B ELLIS | 115 E PALM DR STE 1 | LAKELAND | FL | 33803 | 101 | 458 | |
| 000015279FL | ORAL SURGEON | RIGO CORNEJO | 400 AVENUE K SE STE 14A | WINTER HAVEN | FL | 33880 | 93 | 408 | |
| 000016294FL | GENERAL DENTIST | GERALD V CERDAN | 501 E CENTRAL AVE | WINTER HAVEN | FL | 33880 | 93 | 464 | |
| 000015652FL | GENERAL DENTIST | MASSIMILIANO FORNI | 701 STATE ROAD 60 E | LAKE WALES | FL | 33853 | 91 | 375 | |
| 000014466FL | ORAL SURGEON | EDWARD J MESZAROS | 1736 E EDGEWOOD DR | LAKELAND | FL | 33803 | 84 | 324 | |
| 000017773FL | GENERAL DENTIST | JEROME CERDAN | 501 E CENTRAL AVE | WINTER HAVEN | FL | 33880 | 84 | 379 | |
| 000007870FL | GENERAL DENTIST | ROBERT K HULEN | 226 DOMARIS AVE | LAKE WALES | FL | 33853 | 84 | 254 | |
| 000008256FL | GENERAL DENTIST | PAUL S SAARI | 5050 S LAKELAND DR | LAKELAND | FL | 33813 | 81 | 353 | |
| 000006425FL | GENERAL DENTIST | CHARLES D LLANO | 320 W HIGHLAND DR | LAKELAND | FL | 33813 | 79 | 367 | |
| 000012177FL | ENDODONTIST | STEVEN C MCNUTT | 320 AVENUE K SE STE 2 | WINTER HAVEN | FL | 33880 | 77 | 96 | |
| 000012501FL | GENERAL DENTIST | HECTOR A GONZALEZ | 23871 HWY 27 | LAKE WALES | FL | 33859 | 77 | 433 | |
| 000008413FL | GENERAL DENTIST | FREDERICK D THURSTON | 308 E PARK ST | AUBURNDALE | FL | 33823 | 75 | 509 | |
| 000006458FL | GENERAL DENTIST | ALAN SIZEMORE | 501 E CENTRAL AVE | WINTER HAVEN | FL | 33880 | 75 | 286 | |
| 000017004FL | GENERAL DENTIST | CHRISTOPHER S NOWACKI | 1202 MILLENNIUM PKWY | BRANDON | FL | 33511 | 73 | 670 | |
| 000017171FL | GENERAL DENTIST | RASSEL EL HAMARAH | 1020 5TH ST SE | WINTER HAVEN | FL | 33880 | 72 | 541 | |
| 000010671FL | GENERAL DENTIST | EDWARD J WILLIAMS | 6958 SHIMMERING DR | LAKELAND | FL | 33813 | 72 | 552 | |
| 000019817FL | GENERAL DENTIST | TORI STEELE GRIEB | 2222 E COUNTY ROAD 540A | LAKELAND | FL | 33813 | 71 | 575 | |
| 000014393FL | GENERAL DENTIST | STEVE G WANG | 329 CYPRESS GARDENS BLVD | WINTER HAVEN | FL | 33880 | 70 | 496 | |
| 000010460FL | GENERAL DENTIST | JAMES E CARROLL | 2156 HARDEN BLVD | LAKELAND | FL | 33803 | 70 | 295 | |
| 000014475FL | GENERAL DENTIST | JOHN I PARK | 400 AVENUE K SE STE 12 | WINTER HAVEN | FL | 33880 | 69 | 336 | |
| 000006914FL | GENERAL DENTIST | ANDREW MCKEVENY | 4145 US HIGHWAY 98 N | LAKELAND | FL | 33809 | 65 | 282 | |
| 000013748FL | GENERAL DENTIST | BRIAN TATE CROSBY | 2154 HARDEN BLVD | LAKELAND | FL | 33803 | 64 | 378 | |
| 000014297FL | GENERAL DENTIST | SIMON FIRER | 7375 US HIGHWAY 98 N | LAKELAND | FL | 33809 | 62 | 266 | |
| 000014673FL | PROSTHODONTIST | ELA M TORRES-MOORE | 200 AVENUE K SE STE 4 | WINTER HAVEN | FL | 33880 | 62 | 265 | |
| 000018111FL | GENERAL DENTIST | JOSE G CRUZ | 6390 CYPRESS GARDENS BLVD | WINTER HAVEN | FL | 33884 | 60 | 338 | |
| 000009290FL | GENERAL DENTIST | DAVID W MURCHISON JR | 200 AVENUE K SE STE 4 | WINTER HAVEN | FL | 33880 | 60 | 231 | |
| 000006817FL | GENERAL DENTIST | GERALD W GRINER | 200 AVENUE K SE # 1 | WINTER HAVEN | FL | 33880 | 58 | 249 | |
| 000010135FL | GENERAL DENTIST | STEVEN D REDDICK | 440 S BUCKMOORE RD | LAKE WALES | FL | 33853 | 58 | 278 | |
| 000012365FL | PEDIATRIC DENTIST | NANCY MONTGOMERY-WARE | 225 IMPERIAL BLVD # 3 | LAKELAND | FL | 33803 | 58 | 413 | |
| 000017709FL | GENERAL DENTIST | OMAYRA TORRES | 7700 LAKE WILSON RD | DAVENPORT | FL | 33896 | 58 | 307 | |
| 000019132FL | GENERAL DENTIST | KIMBERLY LYNN BOYETT | 3615 S FLORIDA AVE STE 850 | LAKELAND | FL | 33803 | 56 | 405 | |
| 000016109FL | GENERAL DENTIST | MARIELA K LUNG | 5055 S LAKELAND DR | LAKELAND | FL | 33813 | 53 | 326 | |
| 000016986FL | GENERAL DENTIST | JOSE F LOPEZ | 2300 DEER CREEK COMMERCE LN STE 500 | DAVENPORT | FL | 33837 | 53 | 248 | |
| 000016646FL | GENERAL DENTIST | ANDREW P AGNINI | 1805 LAKELAND HILLS BLVD | LAKELAND | FL | 33805 | 52 | 346 | |
| 000007401FL | ORAL SURGEON | HARLEY M RICHARDS | 2150 HARDEN BLVD | LAKELAND | FL | 33803 | 52 | 201 | |
| 000018683FL | GENERAL DENTIST | BLANCA L FERNANDEZ | 5163 US HWY 98 S | LAKELAND | FL | 33812 | 52 | 391 | |
| 000009999FL | GENERAL DENTIST | GEORGE W BUTZ III | 1517 3RD ST SE | WINTER HAVEN | FL | 33880 | 52 | 243 | |
| 000012942FL | GENERAL DENTIST | RAYMOND M PARRA | 2213 NORTH BLVD W | DAVENPORT | FL | 33837 | 50 | 235 | |
| 000006404FL | GENERAL DENTIST | THOMAS R JOHNSON | 3265 CYPRESS GARDENS RD | WINTER HAVEN | FL | 33884 | 50 | 261 | |
| 000018829FL | GENERAL DENTIST | JEFFREY A MARTIN | 2153 E COUNTY ROAD 540A | LAKELAND | FL | 33813 | 50 | 334 | |
| 000015917FL | GENERAL DENTIST | MATTHEW AGNINI | 1805 LAKELAND HILLS BLVD | LAKELAND | FL | 33805 | 49 | 259 | |
| 000011835FL | GENERAL DENTIST | JAMES CLAYTON LANHAM | 115 E PALM DR | LAKELAND | FL | 33803 | 48 | 323 | |
| 000013303FL | GENERAL DENTIST | CHRISTOPHER P LODENQUAI | 117 KERNEYWOOD ST | LAKELAND | FL | 33803 | 48 | 248 | |
| 000010592FL | GENERAL DENTIST | DWIGHT H PATE | 306 PILAKLAKAHA AVE | AUBURNDALE | FL | 33823 | 47 | 234 | |
| 000018127FL | PROSTHODONTIST | CARLOS A POLO-MONTES | 6390 CYPRESS GARDENS BLVD | WINTER HAVEN | FL | 33884 | 46 | 283 | |
| 000006930FL | ORAL SURGEON | LAWRENCE B MUSSER | 2150 HARDEN BLVD | LAKELAND | FL | 33803 | 44 | 154 | |
| 000013085FL | GENERAL DENTIST | CLAUDE A HEARN | 296 1ST ST N | WINTER HAVEN | FL | 33881 | 44 | 283 | |
| 000005964FL | GENERAL DENTIST | MICHAEL F AGNINI | 1805 LAKELAND HILLS BLVD | LAKELAND | FL | 33805 | 44 | 230 | |
| 000008439FL | GENERAL DENTIST | RONALD L JAMES | 2024 EDGEWOOD DR S STE 2 | LAKELAND | FL | 33803 | 44 | 174 | |
| 000020162FL | GENERAL DENTIST | NICOLE SENSABAUGH | 3436 S FLORIDA AVE #100 | LAKELAND | FL | 33803 | 43 | 246 | |
| 000016643FL | GENERAL DENTIST | HENRY ACOSTA | 2016 US HIGHWAY 92 W | AUBURNDALE | FL | 33823 | 42 | 265 | |
| 000007426FL | GENERAL DENTIST | RANDY P JONES | 4335 HIGHLAND PARK BLVD | LAKELAND | FL | 33813 | 42 | 294 | |
| 000020257FL | GENERAL DENTIST | KYLE ALLEN YERTON | 2222 E COUNTY ROAD 540A | LAKELAND | FL | 33813 | 40 | 280 | |
| 000006723FL | PERIODONTIST | JAMES M BELCHER | 3003 S FLORIDA AVE STE 201 | LAKELAND | FL | 33803 | 39 | 108 | |
| 000017074FL | GENERAL DENTIST | WILLIAM A MUELLER III | 3845 S FLORIDA AVE | LAKELAND | FL | 33813 | 38 | 319 | |
| 000011013FL | GENERAL DENTIST | ANTHONY I WONG | 330 S LAKE SHORE WAY | LAKE ALFRED | FL | 33850 | 38 | 198 | |
| 000020272FL | GENERAL DENTIST | MARYAM BANGESH | 24185 HWY 27 | LAKE WALES | FL | 33859 | 36 | 224 | |
| 000016500FL | ENDODONTIST | TERRYL M CRAWFORD | 1602 S FLORIDA AVE | LAKELAND | FL | 33803 | 35 | 228 | |
| 000012379FL | GENERAL DENTIST | PAUL ALLEN PALO | 151 AVENUE F NW | WINTER HAVEN | FL | 33881 | 35 | 252 | |
| 000016468FL | ENDODONTIST | MALISSA VACHARAKIAT | 1008 5TH SE ST | WINTER HAVEN | FL | 33880 | 34 | 172 | |
| 000017075FL | GENERAL DENTIST | KAWVEH NOFALLAH | 3624 HARDEN BLVD | LAKELAND | FL | 33803 | 34 | 225 | |
| 000004587FL | GENERAL DENTIST | DAVID W GOLDSTON | 120 CARTER BLVD STE 7 | POLK CITY | FL | 33868 | 34 | 458 |
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