Pristine Dental Care

Pristine Dental Care was paid $69K by Medicaid between Aug 2023 and Dec 2024, across 11 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 21% of everything it billed.

33Billing provider infoPRISTINE DENTAL CARE
AUBURN HILLS, MI 48326

33aNPI1437758398assigned 10/21/2020

33bProvider typeDentist

28Total paid$69K

24GClaims1,325

24DCodes billed11

24AFirst – last monthAug 2023 – Dec 2024

Compared with peers

Next to other Dentist providers in Michigan

Rank by total paid#304 of 1,033

Median peer was paid$15K

This provider vs. median4.6×

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
2023	154	$6K
2024incomplete	1,171	$63K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	21%	132	57	$15K
D0150	Comprehensive oral evaluation - new or established patient	16%	271	271	$11K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	16%	85	41	$11K
D1110	Prophylaxis - adult	15%	224	224	$11K
D0210	Intraoral - complete series of radiographic images	14%	146	146	$10K
D0220	Intraoral - periapical first radiographic image	4.4%	196	177	$3K
D2391	Resin-based composite - one surface, posterior, primary or permanent	3.7%	26	13	$3K
D1206	Topical application of fluoride varnish	2.9%	80	80	$2K
D1120	Dental cleaning, childProphylaxis - child	2.6%	44	43	$2K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	2.0%	58	58	$1K
D0230	Intraoral - periapical each additional radiographic image	<1%	63	44	$607.50

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 officialJOSEPH, DERRICK (DOCTOR)