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.

View the file

Other files for this state and local contract opportunity

Other files attached to Group Dental Plan, newest first.
File Type Posted
048-PLA-0515_Renewal_for_2021_and_2022.pdf PDF
RFP_048-PLA-0515_Board_Approval_Renewal_2019-2020.pdf PDF
048-PLA-0515_Renewal_RFP-Group_Dental_Plan_2018-2020_.pdf PDF
Attachment_D-Certificate_of_Coverage.pdf PDF
NRBA_048-PLA-0515.pdf 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 PDF
Addendum_01.pdf PDF
Attachment_C-_Top_Dental_Procedures.xlsx XLSX spreadsheet
Attachment_G-Updated_Experience_Report.xlsx XLSX spreadsheet
Addendum_02.pdf PDF
Award_048-PLA-0515.pdf PDF
Show all 16

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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.
LICENSESPECIALTYNAMEADDRESSCITYSTATEZIPCLAIMANTSCLAIMSIn-network
000007209FLGENERAL DENTISTBILLY B BROWN JR695 S BROADWAY AVEBARTOWFL338303802237
000012385FLGENERAL DENTISTTHOMAS F PLUNKETT200 LAKE HARRIS DRLAKELANDFL338133312202
000005979FLPEDIATRIC DENTISTHARRY BOPP1111 N PARKWAY FRONTAGE RDLAKELANDFL338033272418
000009526FLGENERAL DENTISTPHILLIP E ABBOTT780 E MAIN STBARTOWFL338302731398
000013636FLGENERAL DENTISTROBERT M PRISBE3835 S FLORIDA AVELAKELANDFL338132341527
000011387FLGENERAL DENTISTJAMES A TRUITT144 AVENUE B NWWINTER HAVENFL33881221988
000010569FLGENERAL DENTISTLINDA J MAY1495 E MAIN STBARTOWFL338302121397
000015466FLGENERAL DENTISTJAMIE W ODOM361 E CENTRAL AVEWINTER HAVENFL338802011002
000010739FLGENERAL DENTISTSIUHUNG H FAN211 E LIME STLAKELANDFL33801201806
000017361FLGENERAL DENTISTPATRICK MICHAEL FERRY715 S BROADWAY AVEBARTOWFL33830185957
000007033FLGENERAL DENTISTCRAIG W VALENTINE310 E HIGHLAND DRLAKELANDFL33813166620
000008379FLGENERAL DENTISTGLENN R SHEUMAKER JR6731 US HIGHWAY 98 NLAKELANDFL33809165865
000017195FLPEDIATRIC DENTISTEDWARD JORDAN TARVER1111 N PARKWAY FRONTAGE RDLAKELANDFL338031621205
000008327FLGENERAL DENTISTBRADLEY W BARTEL150 AVENUE A SEWINTER HAVENFL33880161774
000011515FLPEDIATRIC DENTISTKENNETH BENJAMINE ROGERS1550 1ST ST SWINTER HAVENFL33880158942
000011131FLGENERAL DENTISTBELKIS Z JONES5406 STRICKLAND AVELAKELANDFL33812157827
000013488FLGENERAL DENTISTSTEVEN CIARAVINO294 PATTERSON RDHAINES CITYFL33844148732
000014392FLGENERAL DENTISTSTEPHEN J WALDING III3615 S FLORIDA AVE STE 850LAKELANDFL338031411187
000007428FLGENERAL DENTISTGARY L JOYNER2025 FLAMINGO DRBARTOWFL33830140614
000018565FLGENERAL DENTISTDIANA K CRAFT310 E HIGHLAND DRLAKELANDFL33813138727
000018925FLPEDIATRIC DENTISTTIFFANY YI-TING CHEN1550 1ST ST SWINTER HAVENFL33880137937
000015580FLGENERAL DENTISTWILLIAM NERESTANT607 S MISSOURI AVELAKELANDFL33815132834
000018375FLGENERAL DENTISTNHUNG THANH NONG5535 CYPRESS GARDENS BLVD STE 120WINTER HAVENFL33884131754
000016935FLENDODONTISTHAIDER ALZUBAIDI3003 S FLORIDA AVE STE 101LAKELANDFL33803128603
000006787FLGENERAL DENTISTTHOMAS A FELLNER24174 HWY 27 STE 200LAKE WALESFL33859125780
000019011FLPEDIATRIC DENTISTERIN SMITH BERLING5710 US HIGHWAY 98 NLAKELANDFL338091231194
000006080FLGENERAL DENTISTKENNETH L MUNDY4326 HIGHLAND PARK BLVDLAKELANDFL33813121557
000018539FLORAL SURGEONJOSE LUIS LEON RAMIREZ400 AVENUE K SE STE 14AWINTER HAVENFL33880120405
000012653FLPERIODONTISTJEFFRY D BARNES320 AVENUE K SE STE 1WINTER HAVENFL33880119355
000013330FLGENERAL DENTISTFARID MOGHADASI5608 US HIGHWAY 98 NLAKELANDFL33809119471
000014269FLPERIODONTISTDAVID A CAMPBELL3003 S FLORIDA AVE STE 201LAKELANDFL33803118367
000012434FLPEDIATRIC DENTISTSHIRIN YASREBI2015 E EDGEWOOD DRLAKELANDFL33803114906
000014558FLGENERAL DENTISTLEA D WHEELER4406 S FLORIDA AVE STE 29LAKELANDFL33813110579
000008002FLGENERAL DENTISTCHARLES R FORT330 E BROADWAY STFORT MEADEFL33841110509
000007070FLGENERAL DENTISTWILLIAM F CARDMAN4455 FLORIDA NATIONAL DRLAKELANDFL33813107693
000015138FLGENERAL DENTISTERIC L EBUEN4204 US HIGHWAY 98 NLAKELANDFL33809105900
000017859FLGENERAL DENTISTJENNIFER O MARINO1375 TOWN CENTER DRLAKELANDFL33803103927
000010646FLGENERAL DENTISTJENNIFER M STIDHAM620 E DAVIDSON STBARTOWFL33830102574
000008151FLGENERAL DENTISTJOHN B ELLIS115 E PALM DR STE 1LAKELANDFL33803101458
000015279FLORAL SURGEONRIGO CORNEJO400 AVENUE K SE STE 14AWINTER HAVENFL3388093408
000016294FLGENERAL DENTISTGERALD V CERDAN501 E CENTRAL AVEWINTER HAVENFL3388093464
000015652FLGENERAL DENTISTMASSIMILIANO FORNI701 STATE ROAD 60 ELAKE WALESFL3385391375
000014466FLORAL SURGEONEDWARD J MESZAROS1736 E EDGEWOOD DRLAKELANDFL3380384324
000017773FLGENERAL DENTISTJEROME CERDAN501 E CENTRAL AVEWINTER HAVENFL3388084379
000007870FLGENERAL DENTISTROBERT K HULEN226 DOMARIS AVELAKE WALESFL3385384254
000008256FLGENERAL DENTISTPAUL S SAARI5050 S LAKELAND DRLAKELANDFL3381381353
000006425FLGENERAL DENTISTCHARLES D LLANO320 W HIGHLAND DRLAKELANDFL3381379367
000012177FLENDODONTISTSTEVEN C MCNUTT320 AVENUE K SE STE 2WINTER HAVENFL338807796
000012501FLGENERAL DENTISTHECTOR A GONZALEZ23871 HWY 27LAKE WALESFL3385977433
000008413FLGENERAL DENTISTFREDERICK D THURSTON308 E PARK STAUBURNDALEFL3382375509
000006458FLGENERAL DENTISTALAN SIZEMORE501 E CENTRAL AVEWINTER HAVENFL3388075286
000017004FLGENERAL DENTISTCHRISTOPHER S NOWACKI1202 MILLENNIUM PKWYBRANDONFL3351173670
000017171FLGENERAL DENTISTRASSEL EL HAMARAH1020 5TH ST SEWINTER HAVENFL3388072541
000010671FLGENERAL DENTISTEDWARD J WILLIAMS6958 SHIMMERING DRLAKELANDFL3381372552
000019817FLGENERAL DENTISTTORI STEELE GRIEB2222 E COUNTY ROAD 540ALAKELANDFL3381371575
000014393FLGENERAL DENTISTSTEVE G WANG329 CYPRESS GARDENS BLVDWINTER HAVENFL3388070496
000010460FLGENERAL DENTISTJAMES E CARROLL2156 HARDEN BLVDLAKELANDFL3380370295
000014475FLGENERAL DENTISTJOHN I PARK400 AVENUE K SE STE 12WINTER HAVENFL3388069336
000006914FLGENERAL DENTISTANDREW MCKEVENY4145 US HIGHWAY 98 NLAKELANDFL3380965282
000013748FLGENERAL DENTISTBRIAN TATE CROSBY2154 HARDEN BLVDLAKELANDFL3380364378
000014297FLGENERAL DENTISTSIMON FIRER7375 US HIGHWAY 98 NLAKELANDFL3380962266
000014673FLPROSTHODONTISTELA M TORRES-MOORE200 AVENUE K SE STE 4WINTER HAVENFL3388062265
000018111FLGENERAL DENTISTJOSE G CRUZ6390 CYPRESS GARDENS BLVDWINTER HAVENFL3388460338
000009290FLGENERAL DENTISTDAVID W MURCHISON JR200 AVENUE K SE STE 4WINTER HAVENFL3388060231
000006817FLGENERAL DENTISTGERALD W GRINER200 AVENUE K SE # 1WINTER HAVENFL3388058249
000010135FLGENERAL DENTISTSTEVEN D REDDICK440 S BUCKMOORE RDLAKE WALESFL3385358278
000012365FLPEDIATRIC DENTISTNANCY MONTGOMERY-WARE225 IMPERIAL BLVD # 3LAKELANDFL3380358413
000017709FLGENERAL DENTISTOMAYRA TORRES7700 LAKE WILSON RDDAVENPORTFL3389658307
000019132FLGENERAL DENTISTKIMBERLY LYNN BOYETT3615 S FLORIDA AVE STE 850LAKELANDFL3380356405
000016109FLGENERAL DENTISTMARIELA K LUNG5055 S LAKELAND DRLAKELANDFL3381353326
000016986FLGENERAL DENTISTJOSE F LOPEZ2300 DEER CREEK COMMERCE LN STE 500DAVENPORTFL3383753248
000016646FLGENERAL DENTISTANDREW P AGNINI1805 LAKELAND HILLS BLVDLAKELANDFL3380552346
000007401FLORAL SURGEONHARLEY M RICHARDS2150 HARDEN BLVDLAKELANDFL3380352201
000018683FLGENERAL DENTISTBLANCA L FERNANDEZ5163 US HWY 98 SLAKELANDFL3381252391
000009999FLGENERAL DENTISTGEORGE W BUTZ III1517 3RD ST SEWINTER HAVENFL3388052243
000012942FLGENERAL DENTISTRAYMOND M PARRA2213 NORTH BLVD WDAVENPORTFL3383750235
000006404FLGENERAL DENTISTTHOMAS R JOHNSON3265 CYPRESS GARDENS RDWINTER HAVENFL3388450261
000018829FLGENERAL DENTISTJEFFREY A MARTIN2153 E COUNTY ROAD 540ALAKELANDFL3381350334
000015917FLGENERAL DENTISTMATTHEW AGNINI1805 LAKELAND HILLS BLVDLAKELANDFL3380549259
000011835FLGENERAL DENTISTJAMES CLAYTON LANHAM115 E PALM DRLAKELANDFL3380348323
000013303FLGENERAL DENTISTCHRISTOPHER P LODENQUAI117 KERNEYWOOD STLAKELANDFL3380348248
000010592FLGENERAL DENTISTDWIGHT H PATE306 PILAKLAKAHA AVEAUBURNDALEFL3382347234
000018127FLPROSTHODONTISTCARLOS A POLO-MONTES6390 CYPRESS GARDENS BLVDWINTER HAVENFL3388446283
000006930FLORAL SURGEONLAWRENCE B MUSSER2150 HARDEN BLVDLAKELANDFL3380344154
000013085FLGENERAL DENTISTCLAUDE A HEARN296 1ST ST NWINTER HAVENFL3388144283
000005964FLGENERAL DENTISTMICHAEL F AGNINI1805 LAKELAND HILLS BLVDLAKELANDFL3380544230
000008439FLGENERAL DENTISTRONALD L JAMES2024 EDGEWOOD DR S STE 2LAKELANDFL3380344174
000020162FLGENERAL DENTISTNICOLE SENSABAUGH3436 S FLORIDA AVE #100LAKELANDFL3380343246
000016643FLGENERAL DENTISTHENRY ACOSTA2016 US HIGHWAY 92 WAUBURNDALEFL3382342265
000007426FLGENERAL DENTISTRANDY P JONES4335 HIGHLAND PARK BLVDLAKELANDFL3381342294
000020257FLGENERAL DENTISTKYLE ALLEN YERTON2222 E COUNTY ROAD 540ALAKELANDFL3381340280
000006723FLPERIODONTISTJAMES M BELCHER3003 S FLORIDA AVE STE 201LAKELANDFL3380339108
000017074FLGENERAL DENTISTWILLIAM A MUELLER III3845 S FLORIDA AVELAKELANDFL3381338319
000011013FLGENERAL DENTISTANTHONY I WONG330 S LAKE SHORE WAYLAKE ALFREDFL3385038198
000020272FLGENERAL DENTISTMARYAM BANGESH24185 HWY 27LAKE WALESFL3385936224
000016500FLENDODONTISTTERRYL M CRAWFORD1602 S FLORIDA AVELAKELANDFL3380335228
000012379FLGENERAL DENTISTPAUL ALLEN PALO151 AVENUE F NWWINTER HAVENFL3388135252
000016468FLENDODONTISTMALISSA VACHARAKIAT1008 5TH SE STWINTER HAVENFL3388034172
000017075FLGENERAL DENTISTKAWVEH NOFALLAH3624 HARDEN BLVDLAKELANDFL3380334225
000004587FLGENERAL DENTISTDAVID W GOLDSTON120 CARTER BLVD STE 7POLK CITYFL3386834458

File details come from the government source that posted it. Updated .