Legendary Smiles, P.C.

Legendary Smiles, P.C. was paid $13K by Medicaid between Mar 2018 and Feb 2024, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 40% of everything it billed.

33Billing provider infoLEGENDARY SMILES, P.C.
WATFORD CITY, ND 58854

33aNPI1023463320assigned 04/25/2016

33bProvider typeDental Clinic/Center

28Total paid$13K

24GClaims470

24DCodes billed4

24AFirst – last monthMar 2018 – Feb 2024

Compared with peers

Next to other Dental Clinic/Center providers in North Dakota

Rank by total paid#25 of 45

Median peer was paid$17K

This provider vs. median0.7×

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
2018	64	$2K
2019	64	$2K
2020	17	$316.08
2021	99	$3K
2022	146	$4K
2023	67	$2K
2024incomplete	13	$432.25

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	40%	192	175	$5K
D1206	Topical application of fluoride varnish	39%	209	190	$5K
D1120	Dental cleaning, childProphylaxis - child	16%	55	52	$2K
D0150	Comprehensive oral evaluation - new or established patient	5.0%	14	14	$627.39

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 officialBULZOMI, MONTY (OWNER/DENTIST)