Dental
Valleygate Dental Surgery Center of Fayetteville, LLC
Valleygate Dental Surgery Center of Fayetteville, LLC was paid $26.54M by Medicaid between Apr 2018 and Dec 2024, across 22 billing codes. Its largest line is G0330, Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room — 49% of everything it billed.
33Billing provider infoVALLEYGATE DENTAL SURGERY CENTER OF FAYETTEVILLE, LLC
FAYETTEVILLE, NC 28304
FAYETTEVILLE, NC 28304
33aNPI1003321365assigned 12/08/2017
33bProvider typeDentist Anesthesiologist
28Total paid$26.54M
24GClaims90,341
24DCodes billed22
24AFirst – last monthApr 2018 – Dec 2024
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 5,803 | $649K | |
| 2019 | 11,590 | $1.77M | |
| 2020 | 11,807 | $1.91M | |
| 2021 | 19,281 | $2.84M | |
| 2022 | 17,985 | $2.90M | |
| 2023 | 11,271 | $4.31M | |
| 2024incomplete | 12,604 | $12.16M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | 49% | 9,300 | 6,914 | $13.09M |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 25% | 15,922 | 15,620 | $6.74M |
| D2930 | Prefabricated stainless steel crown - primary tooth | 10% | 10,289 | 8,491 | $2.78M |
| D1120 | Dental cleaning, childProphylaxis - child | 8.5% | 5,300 | 4,919 | $2.26M |
| D9222 | 4.4% | 15,907 | 15,606 | $1.17M | |
| D2932 | <1% | 4,751 | 3,914 | $163K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 2,841 | 2,308 | $77K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 2,042 | 1,672 | $65K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 5,162 | 4,210 | $39K |
| D1206 | Topical application of fluoride varnish | <1% | 4,885 | 4,508 | $37K |
| D2330 | <1% | 2,120 | 1,735 | $33K | |
| D1351 | Sealant - per tooth | <1% | 2,773 | 2,277 | $31K |
10 more codes
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 4,452 | $22K |
| D2933 | <1% | 567 | $16K | |
| D2332 | <1% | 472 | $7K | |
| D1510 | <1% | 1,500 | $6K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 210 | $4K |
| D2331 | <1% | 223 | $4K | |
| D3230 | <1% | 1,464 | $3K | |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 59 | $0.00 |
| D1575 | 0% | 14 | $0.00 | |
| D9971 | 0% | 88 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialJONES, VIRGINIA (CHIEF EXECUTIVE OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Valleygate Dental Surgery Center of Charlotte LLC | Charlotte, NC | $26.29M |
| Valleygate Dental Surgery Centers of the West, LLC | Greensboro, NC | $14.22M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.