Clinic
Tooth Town Pediatric Dentistry, PLLC
Tooth Town Pediatric Dentistry, PLLC was paid $1.31M by Medicaid between Aug 2019 and Dec 2024, across 21 billing codes. Its largest line is D1120, dental cleaning, child — 21% of everything it billed.
33Billing provider infoTOOTH TOWN PEDIATRIC DENTISTRY, PLLC
SOUTH LYON, MI 48178
SOUTH LYON, MI 48178
33aNPI1295395739assigned 06/17/2019
33bProvider typeDental Clinic/Center
28Total paid$1.31M
24GClaims34,635
24DCodes billed21
24AFirst – last monthAug 2019 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Michigan
Rank by total paid#37 of 431
Median peer was paid$24K
This provider vs. median54×
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 | |
|---|---|---|---|
| 2019 | 62 | $1K | |
| 2020 | 3,917 | $128K | |
| 2021 | 6,088 | $218K | |
| 2022 | 8,137 | $307K | |
| 2023 | 9,044 | $356K | |
| 2024incomplete | 7,387 | $297K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 21% | 6,573 | 6,572 | $271K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 16% | 6,347 | 6,347 | $211K |
| D1206 | Topical application of fluoride varnish | 14% | 6,830 | 6,829 | $187K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 1,213 | 830 | $149K |
| D1351 | Sealant - per tooth | 6.5% | 2,722 | 834 | $85K |
| D0140 | Limited oral evaluation - problem focused | 4.5% | 944 | 938 | $59K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.4% | 611 | 461 | $57K |
| D0272 | Bitewings - two radiographic images | 4.2% | 2,264 | 2,264 | $54K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 3.5% | 243 | 192 | $46K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.8% | 570 | 569 | $36K |
| D0220 | Intraoral - periapical first radiographic image | 2.7% | 1,953 | 1,940 | $36K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.5% | 2,488 | 1,011 | $33K |
9 more codes
| D0330 | Panoramic radiographic image | 1.3% | 230 | $17K |
| D1110 | Prophylaxis - adult | <1% | 258 | $13K |
| D0240 | <1% | 553 | $12K | |
| D0274 | Bitewings - four radiographic images | <1% | 349 | $12K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 107 | $10K |
| D9248 | <1% | 164 | $10K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 90 | $5K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 51 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 75 | $2K |
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 officialGHEZZI, STEPHEN (OWNER)