Mira Mesa dentist sentenced to 6 years in custody for $866K insurance fraud scheme

Rose Blan

A Mira Mesa dentist was sentenced Wednesday to six years in custody and ordered to pay more than $405,000 in restitution for fraudulently billing 10 insurance companies for hundreds of root canals she did not perform, authorities said. April Rose Ambrosio, 59, pleaded guilty earlier this year to three counts […]

A Mira Mesa dentist was sentenced Wednesday to six years in custody and ordered to pay more than $405,000 in restitution for fraudulently billing 10 insurance companies for hundreds of root canals she did not perform, authorities said.

April Rose Ambrosio, 59, pleaded guilty earlier this year to three counts of insurance fraud as part of a four-year scheme in which she billed the insurance companies $866,700, according to prosecutors and the state insurance commissioner.

Authorities said she was paid $405,633 by the insurance companies. San Diego Superior Court Judge Daniel Goldstein ordered Ambrosio to pay back that money.

She was ordered to serve a split sentence, meaning she will spend three years in county jail and three years on mandatory supervision in the community. California law changed in 2011 to allow some non-violent offenders to serve their prison terms in jail — a situation often described in court as “local prison.”

In September 2019, a judge ordered Ambrosio to stop practicing dentistry. State records show that’s when her license, which was issued in 1990, was suspended.

Authorities said Ambrosio falsely claimed to have performed 800 root canals on 100 patients between 2014 and 2018, even though she lacked the specialized training required to perform root canals.

In some instances, the people she claimed to have performed root canals for had never set foot in her office. In another instance, she billed an insurance company $61,700 for 110 root canals, all of which she claimed to perform on a family of four over just a three-month period in 2016.

“Her deception involved billing for work on days her office was closed, or she was noted as being on vacation,” county prosecutors said in a news release. “In some instances, Ambrosio billed for root canals on non-existent or missing teeth, or she double billed for teeth she previously claimed to have performed root canals on.”

San Diego County District Attorney Summer Stephan said the way Ambrosio “bilked the system” was “astounding.”

“Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums,” Stephan said in a news release.

Ambrosio’s attorney, Kerry Armstrong, said his client “is extremely remorseful” and ready to begin her sentence next week.

“By all accounts, she was a fantastic dentist to her patients,” Armstrong wrote in an email Wednesday night. “And while she possibly will never get to practice dentistry again, she hopes to work in a field where she can help people once she serves her sentence and regains employment again.”

California Department of Insurance personnel investigated Ambrosio for more than two years and worked with the insurance fraud division of the District Attorney’s Office to prosecute the case.

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