Dental
Northeast Pediatric Dental LLC
Northeast Pediatric Dental LLC was paid $1.65M by Medicaid between Jun 2022 and Dec 2024, across 28 billing codes. Its largest line is D1351, Sealant - per tooth — 11% of everything it billed.
33Billing provider infoNORTHEAST PEDIATRIC DENTAL LLC
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
33aNPI1053087759assigned 08/22/2021
33bProvider typePediatric Dentist
28Total paid$1.65M
24GClaims56,673
24DCodes billed28
24AFirst – last monthJun 2022 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Pennsylvania
Rank by total paid#8 of 237
Median peer was paid$109K
This provider vs. median15×
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 | |
|---|---|---|---|
| 2022 | 513 | $11K | |
| 2023 | 3,775 | $79K | |
| 2024incomplete | 52,385 | $1.56M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 11% | 6,398 | 1,456 | $184K |
| D7140 | Extraction, erupted tooth or exposed root | 10% | 2,661 | 1,289 | $173K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.0% | 2,187 | 1,105 | $150K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 8.6% | 2,984 | 2,518 | $143K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.3% | 4,275 | 3,997 | $121K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.0% | 1,004 | 676 | $116K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.7% | 5,439 | 5,038 | $111K |
| D1206 | Topical application of fluoride varnish | 5.6% | 4,809 | 4,473 | $92K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.5% | 1,017 | 647 | $74K |
| D1110 | Prophylaxis - adult | 4.4% | 1,929 | 1,804 | $73K |
| D1330 | 3.2% | 5,845 | 5,410 | $53K | |
| D1310 | 3.1% | 5,850 | 5,415 | $52K |
16 more codes
| D9920 | 2.5% | 748 | $41K | |
| D1208 | Topical application of fluoride, excluding varnish | 2.4% | 2,193 | $39K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.0% | 600 | $33K |
| D0274 | Bitewings - four radiographic images | 2.0% | 1,154 | $33K |
| D0330 | Panoramic radiographic image | 1.9% | 813 | $32K |
| D0272 | Bitewings - two radiographic images | 1.9% | 1,951 | $32K |
| D0140 | Limited oral evaluation - problem focused | 1.7% | 662 | $28K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.6% | 378 | $26K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.0% | 795 | $17K |
| D0603 | <1% | 1,485 | $15K | |
| D0601 | <1% | 636 | $6K | |
| D0240 | <1% | 431 | $5K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 355 | $3K |
| D2332 | <1% | 19 | $2K | |
| D9110 | <1% | 40 | $1K | |
| D2330 | <1% | 15 | $798.05 |
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 officialLEE, WIN (PEDIATRIC DENTIST)