Dental
Staten Island Pediatric Dentistry
Staten Island Pediatric Dentistry was paid $3.47M by Medicaid between Jan 2018 and Nov 2024, across 21 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 18% of everything it billed.
33Billing provider infoSTATEN ISLAND PEDIATRIC DENTISTRY
STATEN ISLAND, NY 10314
STATEN ISLAND, NY 10314
33aNPI1053509687assigned 10/09/2007
33bProvider typePediatric Dentist
28Total paid$3.47M
24GClaims69,163
24DCodes billed21
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatric Dentist providers in New York
Rank by total paid#40 of 514
Median peer was paid$196K
This provider vs. median18×
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 | 9,798 | $514K | |
| 2019 | 11,549 | $606K | |
| 2020 | 11,102 | $513K | |
| 2021 | 13,315 | $683K | |
| 2022 | 13,297 | $686K | |
| 2023 | 9,023 | $433K | |
| 2024incomplete | 1,079 | $39K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 18% | 4,195 | 3,767 | $624K |
| D0274 | Bitewings - four radiographic images | 17% | 12,969 | 12,969 | $581K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 13,821 | 13,821 | $520K |
| D7140 | Extraction, erupted tooth or exposed root | 10% | 2,289 | 2,119 | $357K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 10% | 2,587 | 2,387 | $349K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.2% | 10,502 | 10,502 | $318K |
| D1208 | Topical application of fluoride, excluding varnish | 7.5% | 14,325 | 14,325 | $261K |
| D1110 | Prophylaxis - adult | 3.6% | 4,166 | 4,166 | $126K |
| D1351 | Sealant - per tooth | 3.6% | 1,050 | 804 | $123K |
| D9110 | 1.3% | 807 | 793 | $44K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.2% | 315 | 277 | $42K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.2% | 257 | 242 | $41K |
9 more codes
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.1% | 292 | $40K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 621 | $18K |
| D0330 | Panoramic radiographic image | <1% | 149 | $10K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 409 | $7K |
| D1206 | Topical application of fluoride varnish | <1% | 182 | $5K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 119 | $4K |
| D0140 | Limited oral evaluation - problem focused | <1% | 47 | $2K |
| D9995 | <1% | 44 | $1K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 17 | $373.75 |
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 officialGRIES, DEBORAH (PRESIDENT)