Dental
Ellis Tooth Fairy PLLC
Ellis Tooth Fairy PLLC was paid $129K by Medicaid between Sep 2024 and Dec 2024, across 15 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 14% of everything it billed.
33Billing provider infoELLIS TOOTH FAIRY PLLC
FORT WORTH, TX 76164
FORT WORTH, TX 76164
33aNPI1063251171assigned 05/20/2024
33bProvider typeGeneral Practice Dentistry
28Total paid$129K
24GClaims5,047
24DCodes billed15
24AFirst – last monthSep 2024 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#969 of 2,774
Median peer was paid$43K
This provider vs. median3.0×
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 | |
|---|---|---|---|
| 2024incomplete | 5,047 | $129K |
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 | 14% | 185 | 97 | $18K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 11% | 191 | 117 | $15K |
| D1351 | Sealant - per tooth | 11% | 517 | 156 | $14K |
| D0230 | Intraoral - periapical each additional radiographic image | 10% | 1,200 | 451 | $13K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.8% | 312 | 310 | $11K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.6% | 251 | 250 | $9K |
| D1110 | Prophylaxis - adult | 6.3% | 148 | 148 | $8K |
| D0274 | Bitewings - four radiographic images | 6.2% | 232 | 232 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 5.2% | 460 | 458 | $7K |
| D0145 | Oral evaluation for a patient under three years of age | 5.2% | 47 | 47 | $7K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.7% | 213 | 212 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 4.4% | 466 | 460 | $6K |
3 more codes
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 officialCHEN, YUEXI (MANANGER)
| Provider | Location | Paid |
|---|---|---|
| Smile Alliance, PLLC | Frisco, TX | $1.65M |
| East Dallas Family Dental PLLC | Frisco, TX | $1.49M |
| Mesquite Tooth Fairy PLLC | Mesquite, TX | $903K |
| Irving Tooth Fairy PLLC | Irving, TX | $548K |
| Oakcliff Tooth Fairy PLLC | Dallas, TX | $28K |
| Garland Tooth Fairy, PLLC | Frisco, TX | $518.43 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.