The Kids Dentist LLC

The Kids Dentist LLC was paid $35K by Medicaid between Jan 2018 and Jan 2020, across 7 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 38% of everything it billed.

33Billing provider infoTHE KIDS DENTIST LLC
MEQUON, WI 53092

33aNPI1407257108assigned 09/12/2014

33bProvider typePediatric Dentist

28Total paid$35K

24GClaims1,098

24DCodes billed7

24AFirst – last monthJan 2018 – Jan 2020

Compared with peers

Next to other Pediatric Dentist providers in Wisconsin

Rank by total paid#38 of 61

Median peer was paid$85K

This provider vs. median0.4×

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	595	$24K
2019	435	$9K
2020	68	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2930	Prefabricated stainless steel crown - primary tooth	38%	80	12	$13K
D1120	Dental cleaning, childProphylaxis - child	27%	335	315	$9K
D1206	Topical application of fluoride varnish	15%	327	311	$5K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	8.6%	154	152	$3K
D0272	Bitewings - two radiographic images	5.3%	105	102	$2K
D0150	Comprehensive oral evaluation - new or established patient	3.6%	42	38	$1K
D0240		2.4%	55	28	$829.57

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 officialFISHER, SHANE (OWNER)