Dental
Canyon Modern Dentistry, LLP
Canyon Modern Dentistry, LLP was paid $40K by Medicaid between Jan 2018 and Dec 2019, across 17 billing codes. Its largest line is D1120, dental cleaning, child — 19% of everything it billed.
33Billing provider infoCANYON MODERN DENTISTRY, LLP
SURPRISE, AZ 85388
SURPRISE, AZ 85388
33aNPI1194021170assigned 02/08/2011
33bProvider typeGeneral Practice Dentistry
28Total paid$40K
24GClaims11,974
24DCodes billed17
24AFirst – last monthJan 2018 – Dec 2019
Compared with peers
Next to other General Practice Dentistry providers in Arizona
Rank by total paid#117 of 530
Median peer was paid$920.17
This provider vs. median44×
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 | 5,511 | $18K | |
| 2019 | 6,463 | $23K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 19% | 1,858 | 1,838 | $8K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 18% | 564 | 254 | $7K |
| D1206 | Topical application of fluoride varnish | 11% | 2,135 | 2,117 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 10% | 1,780 | 1,391 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.1% | 679 | 674 | $4K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.1% | 1,387 | 1,377 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 6.0% | 1,637 | 1,610 | $2K |
| D0330 | Panoramic radiographic image | 5.5% | 292 | 291 | $2K |
| D0274 | Bitewings - four radiographic images | 5.2% | 494 | 489 | $2K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.5% | 429 | 376 | $997.57 |
| D1110 | Prophylaxis - adult | 1.8% | 82 | 80 | $733.84 |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.8% | 24 | 13 | $731.64 |
5 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 officialMALLORY, JAMES (OWNER DOCTOR)