Main Street Dental

Main Street Dental was paid $12K by Medicaid between Jul 2018 and Jul 2021, across 7 billing codes. Its largest line is D0330, Panoramic radiographic image — 36% of everything it billed.

33Billing provider infoMAIN STREET DENTAL
SOUTHAVEN, MS 38671

33aNPI1043557085assigned 01/10/2013

33bProvider typeDentist

28Total paid$12K

24GClaims2,311

24DCodes billed7

24AFirst – last monthJul 2018 – Jul 2021

Compared with peers

Next to other Dentist providers in Mississippi

Rank by total paid#185 of 261

Median peer was paid$64K

This provider vs. median0.2×

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	1,323	$4K
2019	684	$5K
2020	292	$3K
2021	12	$517.90

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0330	Panoramic radiographic image	36%	525	150	$4K
D1120	Dental cleaning, childProphylaxis - child	20%	584	142	$2K
D0140	Limited oral evaluation - problem focused	19%	327	79	$2K
D0150	Comprehensive oral evaluation - new or established patient	8.8%	289	53	$1K
D1208	Topical application of fluoride, excluding varnish	5.5%	402	89	$669.86
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	5.3%	95	39	$644.50
D1206	Topical application of fluoride varnish	5.1%	89	26	$618.80

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 officialBRADDY, JARAD (MEMBER)