Dental
Davis Square Dental Specialists LLC
Davis Square Dental Specialists LLC was paid $1.70M by Medicaid between Jan 2018 and Nov 2019, across 12 billing codes. Its largest line is D2391, Resin-based composite - one surface, posterior, primary or permanent — 42% of everything it billed.
33Billing provider infoDAVIS SQUARE DENTAL SPECIALISTS LLC
LAWRENCE, MA 01840
LAWRENCE, MA 01840
33aNPI1295173334assigned 06/11/2013
33bProvider typeDentist
28Total paid$1.70M
24GClaims27,437
24DCodes billed12
24AFirst – last monthJan 2018 – Nov 2019
Compared with peers
Next to other Dentist providers in Massachusetts
Rank by total paid#36 of 413
Median peer was paid$93K
This provider vs. median18×
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 | 12,248 | $734K | |
| 2019 | 15,189 | $963K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 42% | 8,293 | 879 | $718K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 23% | 3,636 | 875 | $390K |
| D4210 | 6.3% | 444 | 190 | $107K | |
| D0274 | Bitewings - four radiographic images | 5.8% | 2,477 | 2,411 | $98K |
| D1110 | Prophylaxis - adult | 5.5% | 1,592 | 1,539 | $93K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.3% | 1,464 | 1,413 | $72K |
| D1208 | Topical application of fluoride, excluding varnish | 3.3% | 1,965 | 1,935 | $55K |
| D0220 | Intraoral - periapical first radiographic image | 2.7% | 2,580 | 2,508 | $46K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.6% | 939 | 922 | $44K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.2% | 2,703 | 2,479 | $37K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.9% | 1,195 | 1,171 | $32K |
| D0140 | Limited oral evaluation - problem focused | <1% | 149 | 132 | $5K |
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 officialGONZAGA, KITIA (OFFICE MANAGER)