Dental
Kid Smiles Pediatric Dentistry of Port Jefferson Station PLLC
Kid Smiles Pediatric Dentistry of Port Jefferson Station PLLC was paid $10K by Medicaid between Oct 2023 and Dec 2024, across 5 billing codes. Its largest line is D1120, dental cleaning, child — 50% of everything it billed.
33Billing provider infoKID SMILES PEDIATRIC DENTISTRY OF PORT JEFFERSON STATION PLLC
PORT JEFFERSON STATION, NY 11776
PORT JEFFERSON STATION, NY 11776
33aNPI1144921602assigned 03/13/2023
33bProvider typePediatric Dentist
28Total paid$10K
24GClaims292
24DCodes billed5
24AFirst – last monthOct 2023 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in New York
Rank by total paid#435 of 514
Median peer was paid$196K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2023 | 13 | $617.76 | |
| 2024incomplete | 279 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 50% | 101 | 101 | $5K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 28% | 84 | 84 | $3K |
| D0272 | Bitewings - two radiographic images | 9.2% | 47 | 47 | $883.13 |
| D1208 | Topical application of fluoride, excluding varnish | 7.3% | 45 | 45 | $696.15 |
| D1206 | Topical application of fluoride varnish | 5.2% | 15 | 15 | $497.25 |
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 officialPASTORE, CYNTHIA (INSURANCE COORDINATOR)
| Provider | Location | Paid |
|---|---|---|
| Kiddsmiles Pediatric Dentistry 7 PLLC | Floral Park, NY | $2.46M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.