Park Dental Group, LLC

Park Dental Group, LLC was paid $43K by Medicaid between Jan 2018 and Oct 2023, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 26% of everything it billed.

33Billing provider infoPARK DENTAL GROUP, LLC
ROCK HILL, SC 29732

33aNPI1275908923assigned 12/07/2015

33bProvider typeGeneral Practice Dentistry

28Total paid$43K

24GClaims1,134

24DCodes billed8

24AFirst – last monthJan 2018 – Oct 2023

Compared with peers

Next to other General Practice Dentistry providers in South Carolina

Rank by total paid#195 of 331

Median peer was paid$75K

This provider vs. median0.6×

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	329	$17K
2019	387	$15K
2020	127	$6K
2021	65	$1K
2022	123	$3K
2023	103	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	26%	223	223	$11K
D0150	Comprehensive oral evaluation - new or established patient	19%	204	204	$8K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	16%	74	36	$7K
D0330	Panoramic radiographic image	15%	131	131	$7K
D0274	Bitewings - four radiographic images	11%	175	175	$5K
D1208	Topical application of fluoride, excluding varnish	8.9%	235	235	$4K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	3.4%	63	63	$1K
D0220	Intraoral - periapical first radiographic image	<1%	29	27	$328.64

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 officialPARK, JAE SUNG (PRESIDENT)