Dental
Centerille Pediatric Dentistry, Kyle R Jackson, DDS, INC
Centerille Pediatric Dentistry, Kyle R Jackson, DDS, INC was paid $4.73M by Medicaid between Jan 2018 and Dec 2024, across 25 billing codes. Its largest line is D1120, dental cleaning, child — 15% of everything it billed.
33Billing provider infoCENTERILLE PEDIATRIC DENTISTRY, KYLE R JACKSON, DDS, INC
CENTERVILLE, OH 45459
CENTERVILLE, OH 45459
33aNPI1386073112assigned 11/02/2013
33bProvider typePediatric Dentist
28Total paid$4.73M
24GClaims166,708
24DCodes billed25
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Ohio
Rank by total paid#7 of 144
Median peer was paid$140K
This provider vs. median34×
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 | 34,793 | $920K | |
| 2019 | 33,499 | $853K | |
| 2020 | 22,362 | $595K | |
| 2021 | 23,601 | $639K | |
| 2022 | 22,235 | $574K | |
| 2023 | 11,789 | $290K | |
| 2024incomplete | 18,429 | $858K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 15% | 30,227 | 29,566 | $710K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 32,673 | 31,990 | $683K |
| D1206 | Topical application of fluoride varnish | 14% | 33,514 | 32,782 | $681K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 14% | 5,220 | 1,500 | $641K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.3% | 7,247 | 3,846 | $441K |
| D1351 | Sealant - per tooth | 6.4% | 12,913 | 3,890 | $303K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.5% | 7,943 | 7,605 | $258K |
| D0272 | Bitewings - two radiographic images | 4.0% | 15,658 | 15,320 | $189K |
| D7140 | Extraction, erupted tooth or exposed root | 4.0% | 2,730 | 1,241 | $187K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.8% | 2,927 | 1,937 | $179K |
| D1110 | Prophylaxis - adult | 3.5% | 3,772 | 3,685 | $163K |
| D0330 | Panoramic radiographic image | 1.4% | 1,206 | 1,183 | $66K |
13 more codes
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 629 | $45K |
| D0240 | <1% | 4,109 | $44K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 1,594 | $40K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,463 | $39K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 646 | $37K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,044 | $7K |
| D1354 | <1% | 391 | $7K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 33 | $4K |
| D0274 | Bitewings - four radiographic images | <1% | 57 | $2K |
| D2140 | <1% | 29 | $1K | |
| D0350 | <1% | 39 | $893.76 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 15 | $117.96 |
| D9420 | 0% | 629 | $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 officialJACKSON, KYLE (DENTIST/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Jackson Dental Group, LLC | West Chester, OH | $27K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.