Clinic
Kings Park Dental, LLC
Kings Park Dental, LLC was paid $37K by Medicaid between Aug 2021 and Aug 2024, across 11 billing codes. Its largest line is D1110, Prophylaxis - adult — 35% of everything it billed.
33Billing provider infoKINGS PARK DENTAL, LLC
SPRINGFIELD, VA 22151
SPRINGFIELD, VA 22151
33aNPI1225640394assigned 08/20/2020
33bProvider typeDental Clinic/Center
28Total paid$37K
24GClaims2,160
24DCodes billed11
24AFirst – last monthAug 2021 – Aug 2024
Compared with peers
Next to other Dental Clinic/Center providers in Virginia
Rank by total paid#81 of 142
Median peer was paid$75K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2021 | 117 | $3K | |
| 2022 | 518 | $16K | |
| 2023 | 1,112 | $17K | |
| 2024incomplete | 413 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 35% | 432 | 418 | $13K |
| D0274 | Bitewings - four radiographic images | 15% | 290 | 285 | $6K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 436 | 430 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.8% | 107 | 107 | $4K |
| D0210 | Intraoral - complete series of radiographic images | 9.7% | 203 | 68 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 6.2% | 341 | 308 | $2K |
| D9920 | 3.9% | 94 | 75 | $1K | |
| D0140 | Limited oral evaluation - problem focused | 2.8% | 69 | 66 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 2.7% | 72 | 65 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 104 | 70 | $290.60 |
| D1206 | Topical application of fluoride varnish | <1% | 12 | 12 | $249.48 |
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 officialYI, TYLER (OWNER/GENERAL DENTIST)