Dental
Sd-Dezavala PC
Sd-Dezavala PC was paid $15K by Medicaid between Dec 2020 and Dec 2021, across 15 billing codes. Its largest line is D1110, Prophylaxis - adult — 17% of everything it billed.
33Billing provider infoSD-DEZAVALA PC
SAN ANTONIO, TX 78249
SAN ANTONIO, TX 78249
33aNPI1093266306assigned 10/21/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$15K
24GClaims802
24DCodes billed15
24AFirst – last monthDec 2020 – Dec 2021
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#1,754 of 2,774
Median peer was paid$43K
This provider vs. median0.3×
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 PHAM, LYNHTHY 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 | |
|---|---|---|---|
| 2020 | 15 | $155.04 | |
| 2021 | 787 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 17% | 48 | 47 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 11% | 157 | 152 | $2K |
| D1351 | Sealant - per tooth | 11% | 64 | 14 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 11% | 161 | 135 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 10% | 108 | 107 | $1K |
| D0274 | Bitewings - four radiographic images | 9.5% | 49 | 48 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.8% | 27 | 27 | $992.25 |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 6.3% | 34 | 12 | $921.48 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.3% | 33 | 32 | $914.65 |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.1% | 21 | 21 | $741.72 |
| D9222 | 4.0% | 13 | 12 | $585.00 | |
| D0140 | Limited oral evaluation - problem focused | 1.2% | 12 | 12 | $169.02 |
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 officialPHAM, LYNHTHY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| SD Greenville LLC | Greenville, TX | $719K |
| SD Corpus Christi PLLC | Corpus Christi, TX | $557K |
| SD- Roosevelt PC | San Antonio, TX | $314K |
| SD Texarkana | Texarkana, TX | $280K |
| SD- 4315Frederick PC | San Antonio, TX | $218K |
| Smiley Dental Singleton PLLC | Dallas, TX | $215K |
| SD- Potranco, PC | San Antonio, TX | $178K |
| Smiley Dental - University | Denton, TX | $114K |
| Smiley Dental Mccart PLLC | Fort Worth, TX | $55K |
| Smiley Dental Kemp PLLC | Wichita Falls, TX | $47K |
| SD Meadowbrook PLLC | Fort Worth, TX | $26K |
| Sd-Braun, PC | San Antonio, TX | $22K |
| Sd-933Schertz PC | Schertz, TX | $22K |
| Sd-Hwy 78 PC | San Antonio, TX | $20K |
| Smiley Dental Lamar PLLC | Austin, TX | $12K |
| SD Saginaw PLLC | Saginaw, TX | $8K |
| SD Park Row PLLC | Arlington, TX | $6K |
| SD Haltom City PLLC | Haltom City, TX | $4K |
| SD Valley Mills PLLC | Waco, TX | $3K |
| SD Park Lake PLLC | Waco, TX | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.