Dental
104 Dental, PLLC
104 Dental, PLLC was paid $547K by Medicaid between Dec 2019 and Dec 2024, across 13 billing codes. Its largest line is D1110, Prophylaxis - adult — 18% of everything it billed.
33Billing provider info104 DENTAL, PLLC
CORONA, NY 11368
CORONA, NY 11368
33aNPI1104356476assigned 06/19/2017
33bProvider typeGeneral Practice Dentistry
28Total paid$547K
24GClaims23,655
24DCodes billed13
24AFirst – last monthDec 2019 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in New York
Rank by total paid#280 of 2,184
Median peer was paid$54K
This provider vs. median10×
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 | |
|---|---|---|---|
| 2019 | 55 | $848.97 | |
| 2020 | 1,995 | $49K | |
| 2021 | 3,757 | $101K | |
| 2022 | 3,619 | $80K | |
| 2023 | 7,839 | $176K | |
| 2024incomplete | 6,390 | $141K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 18% | 2,406 | 2,406 | $100K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 4,309 | 4,309 | $97K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 16% | 1,383 | 999 | $85K |
| D0274 | Bitewings - four radiographic images | 15% | 3,700 | 3,700 | $82K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 1,570 | 1,570 | $59K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.1% | 752 | 604 | $33K |
| D1208 | Topical application of fluoride, excluding varnish | 6.0% | 2,581 | 2,581 | $33K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.6% | 4,006 | 4,004 | $25K |
| D0220 | Intraoral - periapical first radiographic image | 4.4% | 2,685 | 2,685 | $24K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 58 | 42 | $3K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 60 | 60 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 127 | 127 | $1K |
1 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 18 | $1K |
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 officialSAKHAEE, ARTIN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Metropolitan Smiles Family Dentistry P C | Kew Gardens, NY | $808K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.