Dental
Summit Smiles PLLC
Summit Smiles PLLC was paid $525K by Medicaid between Mar 2023 and Dec 2024, across 13 billing codes. Its largest line is D2740, Crown - porcelain/ceramic — 75% of everything it billed.
33Billing provider infoSUMMIT SMILES PLLC
CENTENNIAL, CO 80112
CENTENNIAL, CO 80112
33aNPI1013662774assigned 02/21/2022
33bProvider typeGeneral Practice Dentistry
28Total paid$525K
24GClaims2,627
24DCodes billed13
24AFirst – last monthMar 2023 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Colorado
Rank by total paid#120 of 521
Median peer was paid$53K
This provider vs. median10.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
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 | |
|---|---|---|---|
| 2023 | 871 | $24K | |
| 2024incomplete | 1,756 | $501K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2740 | Crown - porcelain/ceramic | 75% | 557 | 181 | $392K |
| D2950 | 11% | 438 | 149 | $59K | |
| D0383 | 6.1% | 224 | 222 | $32K | |
| D1110 | Prophylaxis - adult | 2.3% | 241 | 240 | $12K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.5% | 318 | 317 | $8K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 115 | 114 | $6K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 380 | 371 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 25 | 12 | $3K |
| D0274 | Bitewings - four radiographic images | <1% | 99 | 99 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 160 | 160 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 42 | 42 | $2K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 14 | 14 | $1K |
1 more codes
| D1206 | Topical application of fluoride varnish | <1% | 14 | $239.82 |
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 officialLYDIATT, JOHN (OWNER)
Parent organizationSUMMIT SMILES PLLC
| Provider | Location | Paid |
|---|---|---|
| Summit Smiles PLLC | Federal Heights, CO | $179K |
| Advanced Dental Center, PLLC | Federal Heights, CO | $50K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.