Clinic
Southern Maine Pediatric Dentistry
Southern Maine Pediatric Dentistry was paid $465K by Medicaid between Jan 2018 and Dec 2024, across 14 billing codes. Its largest line is D0120, dental checkup, returning patient — 27% of everything it billed.
33Billing provider infoSOUTHERN MAINE PEDIATRIC DENTISTRY
SOUTH PORTLAND, ME 04106
SOUTH PORTLAND, ME 04106
33aNPI1184814568assigned 07/31/2007
33bProvider typeDental Clinic/Center
28Total paid$465K
24GClaims18,605
24DCodes billed14
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Maine
Rank by total paid#6 of 33
Median peer was paid$59K
This provider vs. median7.8×
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 | |
|---|---|---|---|
| 2018 | 2,476 | $50K | |
| 2019 | 2,879 | $59K | |
| 2020 | 1,845 | $38K | |
| 2021 | 2,080 | $41K | |
| 2022 | 2,811 | $81K | |
| 2023 | 2,902 | $86K | |
| 2024incomplete | 3,612 | $110K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 27% | 5,100 | 4,963 | $127K |
| D1120 | Dental cleaning, childProphylaxis - child | 26% | 3,859 | 3,760 | $123K |
| D1206 | Topical application of fluoride varnish | 18% | 5,806 | 5,643 | $86K |
| D1110 | Prophylaxis - adult | 9.6% | 1,172 | 1,128 | $45K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.5% | 335 | 190 | $30K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 6.2% | 987 | 907 | $29K |
| D0272 | Bitewings - two radiographic images | 3.2% | 850 | 832 | $15K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 285 | 276 | $3K |
| D1351 | Sealant - per tooth | <1% | 116 | 38 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 21 | 14 | $2K |
| D0330 | Panoramic radiographic image | <1% | 27 | 25 | $946.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 12 | 12 | $797.64 |
2 more codes
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 officialWIGNALL, WHITNEY (PEDIATRIC DENTIST)