Clinic
Special Smiles Pediatric Dentistry
Special Smiles Pediatric Dentistry was paid $865K by Medicaid between Jan 2018 and Dec 2024, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 14% of everything it billed.
33Billing provider infoSPECIAL SMILES PEDIATRIC DENTISTRY
ZIONSVILLE, IN 46077
ZIONSVILLE, IN 46077
33aNPI1386935203assigned 04/26/2011
33bProvider typeDental Clinic/Center
28Total paid$865K
24GClaims34,559
24DCodes billed19
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Indiana
Rank by total paid#30 of 123
Median peer was paid$191K
This provider vs. median4.5×
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 | 2,431 | $10K | |
| 2019 | 4,171 | $100K | |
| 2020 | 3,428 | $77K | |
| 2021 | 6,511 | $178K | |
| 2022 | 6,439 | $175K | |
| 2023 | 5,752 | $141K | |
| 2024incomplete | 5,827 | $186K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 4,327 | 3,953 | $122K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 5,973 | 5,434 | $116K |
| D1206 | Topical application of fluoride varnish | 12% | 5,082 | 4,628 | $104K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 1,490 | 666 | $98K |
| D1110 | Prophylaxis - adult | 11% | 2,190 | 1,989 | $91K |
| D1351 | Sealant - per tooth | 10.0% | 3,460 | 878 | $86K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.9% | 1,009 | 474 | $51K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.6% | 2,007 | 1,724 | $49K |
| D0272 | Bitewings - two radiographic images | 4.0% | 1,609 | 1,476 | $34K |
| D0220 | Intraoral - periapical first radiographic image | 3.2% | 2,467 | 2,231 | $27K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.4% | 2,144 | 1,858 | $21K |
| D0274 | Bitewings - four radiographic images | 2.1% | 572 | 526 | $18K |
7 more codes
| D0330 | Panoramic radiographic image | 1.9% | 308 | $17K |
| D1208 | Topical application of fluoride, excluding varnish | 1.5% | 1,209 | $13K |
| D7140 | Extraction, erupted tooth or exposed root | 1.1% | 140 | $9K |
| D0240 | <1% | 419 | $5K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 45 | $1K |
| D0140 | Limited oral evaluation - problem focused | <1% | 84 | $1K |
| D1999 | <1% | 24 | $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 officialSATTERFIELD-SIEGEL, JENNIFER (CEO/PEDIATRIC DENTIST)