Dental
Fresh Dental-Shreveport
Fresh Dental-Shreveport was paid $1.27M by Medicaid between Jan 2018 and Feb 2022, across 21 billing codes. Its largest line is D1110, Prophylaxis - adult — 14% of everything it billed.
33Billing provider infoFRESH DENTAL-SHREVEPORT
IRVING, TX 75039
IRVING, TX 75039
33aNPI1073880639assigned 11/28/2011
33bProvider typeDentist
28Total paid$1.27M
24GClaims29,595
24DCodes billed21
24AFirst – last monthJan 2018 – Feb 2022
Compared with peers
Next to other Dentist providers in Texas
Rank by total paid#161 of 1,678
Median peer was paid$35K
This provider vs. median37×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official PU, MARY controls 20+ related entities in our dataset. Read more
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 | 7,648 | $341K | |
| 2019 | 7,589 | $333K | |
| 2020 | 7,039 | $303K | |
| 2021 | 7,034 | $282K | |
| 2022 | 285 | $12K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 14% | 3,927 | 3,818 | $176K |
| D0210 | Intraoral - complete series of radiographic images | 13% | 2,791 | 2,703 | $169K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 1,920 | 1,033 | $169K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 11% | 1,276 | 833 | $145K |
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 3,041 | 2,943 | $138K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.4% | 4,533 | 4,449 | $119K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.7% | 2,542 | 2,519 | $85K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.9% | 724 | 426 | $49K |
| D1208 | Topical application of fluoride, excluding varnish | 3.6% | 2,406 | 2,390 | $46K |
| D0140 | Limited oral evaluation - problem focused | 3.6% | 1,317 | 1,265 | $46K |
| D0272 | Bitewings - two radiographic images | 2.0% | 1,355 | 1,332 | $26K |
| D0274 | Bitewings - four radiographic images | 1.8% | 875 | 835 | $23K |
9 more codes
| D7140 | Extraction, erupted tooth or exposed root | 1.7% | 385 | $21K |
| D1206 | Topical application of fluoride varnish | 1.2% | 657 | $15K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.1% | 127 | $14K |
| D0220 | Intraoral - periapical first radiographic image | 1.0% | 974 | $13K |
| D1351 | Sealant - per tooth | <1% | 235 | $7K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 96 | $4K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 100 | $3K |
| D0330 | Panoramic radiographic image | <1% | 136 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 178 | $2K |
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 officialPU, MARY (VP OF FINANCE)
| Provider | Location | Paid |
|---|---|---|
| Red Rock Dental-Farmington | Irving, TX | $3.59M |
| Sage Dental | Baytown, TX | $2.35M |
| Peppermint Dental-Montgomery LLC | Albuquerque, NM | $2.14M |
| Sage Dental-Deer Park PLLC | La Porte, TX | $1.87M |
| Vinh Ngo Dentistry PLLC | Victoria, TX | $1.65M |
| Element Dental-Bryan PLLC | Bryan, TX | $1.57M |
| Fusion Dental | Irving, TX | $1.49M |
| Element Dental-Conroe PLLC | Irving, TX | $1.49M |
| Gulfside Dental Port Arthur PLLC | Port Arthur, TX | $1.39M |
| Peppermint Dental-Rio Bravo LLC | Albuquerque, NM | $1.29M |
| Fresh Dental-Bossier City | Irving, TX | $1.21M |
| Peppermint Dental-Sherman PLLC | Sherman, TX | $1.17M |
| Element Dental PLLC | Lufkin, TX | $1.06M |
| Rio Dental and Orthodontics LLC | Rio Rancho, NM | $1.00M |
| Element Dental-Humble PLLC | Humble, TX | $942K |
| Gulfside Dental | Beaumont, TX | $939K |
| Legend Dental-Georgetown | Georgetown, TX | $919K |
| Bliss Dental PLLC | Odessa, TX | $827K |
| Bliss Dental Lubbock PLLC | Lubbock, TX | $826K |
| Archstone Dental-Granbury PLLC | Granbury, TX | $817K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.