Dental
Broadway Mall Dental
Broadway Mall Dental was paid $75K by Medicaid between Jan 2018 and Nov 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 34% of everything it billed.
33Billing provider infoBROADWAY MALL DENTAL
HICKSVILLE, NY 11801
HICKSVILLE, NY 11801
33aNPI1225183551assigned 01/25/2007
33bProvider typeDentist
28Total paid$75K
24GClaims2,793
24DCodes billed9
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Dentist providers in New York
Rank by total paid#706 of 1,649
Median peer was paid$49K
This provider vs. median1.5×
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 | 196 | $5K | |
| 2023 | 1,326 | $38K | |
| 2024incomplete | 1,271 | $33K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 34% | 552 | 552 | $26K |
| D0210 | Intraoral - complete series of radiographic images | 18% | 600 | 600 | $13K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 469 | 469 | $11K |
| D0230 | Intraoral - periapical each additional radiographic image | 14% | 470 | 470 | $10K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.3% | 114 | 61 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 7.6% | 501 | 501 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.5% | 50 | 50 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 25 | 25 | $297.50 |
| D0274 | Bitewings - four radiographic images | <1% | 12 | 12 | $295.80 |
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 officialLEVIN, IGOR (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Sunrise Mall Dental PC | Massapequa, NY | $247K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.