Super Smiles Dentistry for Children, PC

Super Smiles Dentistry for Children, PC was paid $72K by Medicaid between Jan 2018 and Oct 2024, across 5 billing codes. Its largest line is D1120, dental cleaning, child — 56% of everything it billed.

33Billing provider infoSUPER SMILES DENTISTRY FOR CHILDREN, PC
WILLINGBORO, NJ 08046

33aNPI1275937872assigned 10/10/2014

33bProvider typePediatric Dentist

28Total paid$72K

24GClaims2,234

24DCodes billed5

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Pediatric Dentist providers in New Jersey

Rank by total paid#135 of 190

Median peer was paid$275K

This provider vs. median0.3×

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	240	$8K
2019	225	$7K
2020	305	$9K
2021	383	$12K
2022	411	$13K
2023	372	$12K
2024incomplete	298	$10K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	56%	882	874	$40K
D1208	Topical application of fluoride, excluding varnish	27%	868	860	$20K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	16%	458	454	$12K
D0150	Comprehensive oral evaluation - new or established patient	<1%	14	14	$350.00
D0220	Intraoral - periapical first radiographic image	<1%	12	12	$60.00

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 officialPACTOVIS, HOWARD (OWNER)