Dental
Lakeshore Pediatric Dentistry PLLC
Lakeshore Pediatric Dentistry PLLC was paid $940K by Medicaid between Dec 2019 and Dec 2024, across 25 billing codes. Its largest line is D1120, dental cleaning, child — 33% of everything it billed.
33Billing provider infoLAKESHORE PEDIATRIC DENTISTRY PLLC
PERU, NY 12972
PERU, NY 12972
33aNPI1114586625assigned 06/08/2019
33bProvider typePediatric Dentist
28Total paid$940K
24GClaims29,478
24DCodes billed25
24AFirst – last monthDec 2019 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in New York
Rank by total paid#116 of 514
Median peer was paid$196K
This provider vs. median4.8×
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 | 233 | $5K | |
| 2020 | 1,932 | $55K | |
| 2021 | 5,317 | $163K | |
| 2022 | 6,935 | $215K | |
| 2023 | 5,126 | $164K | |
| 2024incomplete | 9,935 | $338K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 33% | 7,166 | 7,166 | $306K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 6,036 | 6,036 | $164K |
| D1206 | Topical application of fluoride varnish | 12% | 3,842 | 3,842 | $115K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.3% | 755 | 445 | $69K |
| D0272 | Bitewings - two radiographic images | 6.1% | 3,489 | 3,489 | $57K |
| D1208 | Topical application of fluoride, excluding varnish | 5.5% | 3,664 | 3,664 | $51K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.8% | 1,202 | 1,202 | $36K |
| D1110 | Prophylaxis - adult | 3.5% | 611 | 611 | $33K |
| D1351 | Sealant - per tooth | 3.3% | 603 | 254 | $31K |
| D7140 | Extraction, erupted tooth or exposed root | 3.2% | 639 | 282 | $30K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.5% | 701 | 683 | $14K |
| D0330 | Panoramic radiographic image | <1% | 204 | 204 | $8K |
13 more codes
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 90 | $7K |
| D9310 | <1% | 52 | $4K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 29 | $3K |
| D7962 | <1% | 15 | $3K | |
| D7961 | <1% | 15 | $3K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 78 | $2K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 68 | $884.18 |
| D9430 | <1% | 32 | $656.00 | |
| D0274 | Bitewings - four radiographic images | <1% | 24 | $654.24 |
| D0140 | Limited oral evaluation - problem focused | <1% | 24 | $342.20 |
| D1330 | 0% | 80 | $0.00 | |
| D0603 | 0% | 43 | $0.00 | |
| D0602 | 0% | 16 | $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 officialLACOMBE-SENECAL, COLLEEN (PEDIATRIC DENTIST/OWNER)