Dental
Pediatric Dentistry of Kingston PLLC
Pediatric Dentistry of Kingston PLLC was paid $12.26M by Medicaid between Jan 2018 and Dec 2024, across 37 billing codes. Its largest line is D1120, dental cleaning, child — 19% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF KINGSTON PLLC
KINGSTON, NY 12401
KINGSTON, NY 12401
33aNPI1053651554assigned 02/20/2013
33bProvider typeDentist Anesthesiologist
28Total paid$12.26M
24GClaims311,846
24DCodes billed37
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist Anesthesiologist providers in New York
Rank by total paid#1 of 13
Median peer was paid$1.03M
This provider vs. median12×
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 | 8,031 | $250K | |
| 2019 | 20,200 | $750K | |
| 2020 | 37,185 | $1.36M | |
| 2021 | 60,579 | $2.17M | |
| 2022 | 59,184 | $2.58M | |
| 2023 | 65,692 | $2.68M | |
| 2024incomplete | 60,975 | $2.47M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 19% | 41,080 | 41,057 | $2.31M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 44,269 | 44,252 | $1.71M |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 11,095 | 7,972 | $1.46M |
| D1351 | Sealant - per tooth | 8.5% | 14,152 | 6,507 | $1.04M |
| D1110 | Prophylaxis - adult | 6.3% | 10,362 | 10,356 | $771K |
| D1208 | Topical application of fluoride, excluding varnish | 6.1% | 31,931 | 31,915 | $743K |
| D0272 | Bitewings - two radiographic images | 5.6% | 31,543 | 31,524 | $688K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 5.5% | 2,963 | 2,098 | $674K |
| D1206 | Topical application of fluoride varnish | 5.3% | 17,864 | 17,845 | $655K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.9% | 5,352 | 4,269 | $476K |
| D7140 | Extraction, erupted tooth or exposed root | 2.4% | 3,631 | 2,792 | $293K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.1% | 6,697 | 6,688 | $257K |
25 more codes
| D0220 | Intraoral - periapical first radiographic image | 1.7% | 12,126 | $214K |
| D0274 | Bitewings - four radiographic images | 1.5% | 5,023 | $178K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.4% | 1,221 | $177K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.2% | 1,073 | $152K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | <1% | 328 | $109K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 7,635 | $95K |
| D2332 | <1% | 379 | $67K | |
| D0330 | Panoramic radiographic image | <1% | 704 | $33K |
| D2330 | <1% | 275 | $29K | |
| D9222 | <1% | 298 | $29K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 1,407 | $27K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 2,310 | $26K |
| D2335 | <1% | 92 | $24K | |
| D1354 | <1% | 115 | $7K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 207 | $7K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 166 | $6K |
| D9995 | <1% | 46 | $563.52 | |
| D0270 | <1% | 28 | $480.90 | |
| D1999 | <1% | 10,843 | $150.00 | |
| D0603 | <1% | 12,985 | $50.00 | |
| D1330 | <1% | 23,839 | $25.00 | |
| D0602 | 0% | 7,529 | $0.00 | |
| D0601 | 0% | 1,199 | $0.00 | |
| D1310 | 0% | 945 | $0.00 | |
| D9986 | 0% | 134 | $0.00 |
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 officialJACOBSON, BARRY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Laser Dentistry for Children LLC | Flushing, NY | $12.37M |
| North Country Pediatric Dentistry PLLC | Plattsburgh, NY | $9.49M |
| LDFCB Dentistry | Bronx, NY | $8.66M |
| New Jersey Laser Dentistry | Teaneck, NJ | $8.50M |
| Pediatric Dentistry of Monsey | Suffern, NY | $5.54M |
| Pediatric Dentistry of Albany, PLLC | Albany, NY | $3.91M |
| Green Mountain Pediatric Dentistry, PLLC | South Burlington, VT | $1.29M |
| Laser Dentistry for Children | Teaneck, NJ | $1.17M |
| Pediatric Dentistry on Park PLLC | New York, NY | $392K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.