Grand Teton Dental Care

Grand Teton Dental Care was paid $63K by Medicaid between Jan 2018 and Nov 2022, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 55% of everything it billed.

33Billing provider infoGRAND TETON DENTAL CARE
VICTOR, ID 83455

33aNPI1336457837assigned 09/17/2010

33bProvider typeDental Clinic/Center

28Total paid$63K

24GClaims3,162

24DCodes billed8

24AFirst – last monthJan 2018 – Nov 2022

Compared with peers

Next to other Dental Clinic/Center providers in Idaho

Rank by total paid#17 of 39

Median peer was paid$56K

This provider vs. median1.1×

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	827	$16K
2019	740	$15K
2020	732	$15K
2021	550	$13K
2022	313	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	55%	436	435	$34K
D1120	Dental cleaning, childProphylaxis - child	41%	390	390	$26K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2.1%	23	12	$1K
D0274	Bitewings - four radiographic images	1.8%	211	211	$1K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	<1%	1,061	1,059	$208.94
D0272	Bitewings - two radiographic images	<1%	252	251	$97.32
D1208	Topical application of fluoride, excluding varnish	<1%	399	398	$13.55
D1206	Topical application of fluoride varnish	0%	390	390	$0.00

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 officialCHERRY, ELMER (OWNER)