Dental
Modern Dental Specialist, LLC
Modern Dental Specialist, LLC was paid $40K by Medicaid between Aug 2023 and Dec 2024, across 10 billing codes. Its largest line is D0210, Intraoral - complete series of radiographic images — 37% of everything it billed.
33Billing provider infoMODERN DENTAL SPECIALIST, LLC
HENDERSON, NV 89014
HENDERSON, NV 89014
33aNPI1407541337assigned 04/06/2023
33bProvider typePeriodontist
28Total paid$40K
24GClaims1,552
24DCodes billed10
24AFirst – last monthAug 2023 – Dec 2024
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 | |
|---|---|---|---|
| 2023 | 575 | $12K | |
| 2024incomplete | 977 | $28K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 37% | 296 | 288 | $15K |
| D0150 | Comprehensive oral evaluation - new or established patient | 30% | 467 | 448 | $12K |
| D0220 | Intraoral - periapical first radiographic image | 7.2% | 246 | 234 | $3K |
| D0330 | Panoramic radiographic image | 7.1% | 84 | 79 | $3K |
| D0274 | Bitewings - four radiographic images | 6.8% | 127 | 122 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.5% | 65 | 12 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.0% | 189 | 159 | $1K |
| D1110 | Prophylaxis - adult | 2.8% | 43 | 42 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.7% | 18 | 15 | $691.20 |
| D1206 | Topical application of fluoride varnish | 1.2% | 17 | 15 | $472.85 |
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 officialKOHANTEB, BENNY (DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Modern Dental Specialist, LLC | Las Vegas, NV | $150K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.