Dental
Shield Pediatric Dentistry INC
Shield Pediatric Dentistry INC was paid $4.46M by Medicaid between Aug 2019 and Dec 2024, across 23 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 46% of everything it billed.
33Billing provider infoSHIELD PEDIATRIC DENTISTRY INC
WESTPORT, MA 02790
WESTPORT, MA 02790
33aNPI1396215778assigned 11/28/2018
33bProvider typeOrthodontics and Dentofacial Orthopedic Dentist
28Total paid$4.46M
24GClaims62,448
24DCodes billed23
24AFirst – last monthAug 2019 – Dec 2024
Compared with peers
Next to other Orthodontics and Dentofacial Orthopedic Dentist providers in Massachusetts
Rank by total paid#12 of 116
Median peer was paid$460K
This provider vs. median9.7×
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 | 1,199 | $71K | |
| 2020 | 4,570 | $387K | |
| 2021 | 9,837 | $820K | |
| 2022 | 11,782 | $780K | |
| 2023 | 17,253 | $1.21M | |
| 2024incomplete | 17,807 | $1.19M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 46% | 10,681 | 2,504 | $2.04M |
| D1120 | Dental cleaning, childProphylaxis - child | 9.6% | 8,621 | 8,274 | $429K |
| D7140 | Extraction, erupted tooth or exposed root | 8.6% | 4,088 | 1,563 | $382K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 5.5% | 2,431 | 1,090 | $245K |
| D1206 | Topical application of fluoride varnish | 5.1% | 9,118 | 8,735 | $226K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.2% | 6,753 | 6,447 | $187K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.1% | 1,721 | 814 | $182K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.8% | 2,343 | 2,277 | $124K |
| D2335 | 2.7% | 747 | 271 | $121K | |
| D9110 | 2.4% | 1,510 | 1,444 | $107K | |
| D0140 | Limited oral evaluation - problem focused | 2.4% | 2,382 | 2,245 | $105K |
| D0274 | Bitewings - four radiographic images | 1.7% | 1,835 | 1,773 | $75K |
11 more codes
| D0220 | Intraoral - periapical first radiographic image | 1.2% | 2,838 | $53K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.1% | 2,573 | $49K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 2,738 | $41K |
| D0272 | Bitewings - two radiographic images | <1% | 1,247 | $35K |
| D1110 | Prophylaxis - adult | <1% | 379 | $24K |
| D2332 | <1% | 163 | $21K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 75 | $6K |
| D1351 | Sealant - per tooth | <1% | 90 | $4K |
| D2330 | <1% | 26 | $2K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 15 | $440.00 |
| D0240 | <1% | 74 | $135.00 |
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 officialGONZALEZ, DANIEL (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Liv Well Behavioral | Chandler, AZ | $6.95M |
| Thrive Wellness and Rehab, P.L.L.C | Santa Teresa, NM | $4.13M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.