Dental
Wilshire Oral Surgery & Implant Center
Wilshire Oral Surgery & Implant Center was paid $854K by Medicaid between Jan 2019 and Dec 2024, across 8 billing codes. Its largest line is D9223, Deep sedation/general anesthesia - each subsequent 15 minute increment — 36% of everything it billed.
33Billing provider infoWILSHIRE ORAL SURGERY & IMPLANT CENTER
LOS ANGELES, CA 90025
LOS ANGELES, CA 90025
33aNPI1205370319assigned 12/08/2016
33bProvider typeOral and Maxillofacial Surgery (Dentist)
28Total paid$854K
24GClaims10,128
24DCodes billed8
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Oral and Maxillofacial Surgery (Dentist) providers in California
Rank by total paid#29 of 94
Median peer was paid$192K
This provider vs. median4.4×
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 | 167 | $9K | |
| 2020 | 320 | $15K | |
| 2021 | 1,353 | $109K | |
| 2022 | 1,958 | $161K | |
| 2023 | 3,085 | $282K | |
| 2024incomplete | 3,245 | $278K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 36% | 1,116 | 767 | $305K |
| D0150 | Comprehensive oral evaluation - new or established patient | 20% | 2,607 | 2,595 | $172K |
| D9222 | 11% | 771 | 766 | $93K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 9.0% | 655 | 365 | $77K |
| D0330 | Panoramic radiographic image | 8.5% | 2,432 | 2,418 | $72K |
| D9610 | 7.4% | 1,124 | 766 | $63K | |
| D9430 | 4.8% | 1,293 | 1,233 | $41K | |
| D7240 | Removal of impacted tooth - completely bony | 3.5% | 130 | 51 | $30K |
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 officialSHADI, JONATHAN (PRESIDENT)