Clinic
SJ Summit Dental INC
SJ Summit Dental INC was paid $8K by Medicaid between Mar 2018 and Aug 2024, across 7 billing codes. Its largest line is D0120, dental checkup, returning patient — 70% of everything it billed.
33Billing provider infoSJ SUMMIT DENTAL INC
ARTESIA, CA 90701
ARTESIA, CA 90701
33aNPI1447497177assigned 01/16/2009
33bProvider typeDental Clinic/Center
28Total paid$8K
24GClaims921
24DCodes billed7
24AFirst – last monthMar 2018 – Aug 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#986 of 1,135
Median peer was paid$200K
This provider vs. median0.0×
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 | 88 | $0.00 | |
| 2019 | 209 | $0.00 | |
| 2020 | 27 | $0.00 | |
| 2021 | 155 | $0.00 | |
| 2022 | 172 | $0.00 | |
| 2023 | 207 | $5K | |
| 2024incomplete | 63 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 70% | 314 | 309 | $6K |
| D1110 | Prophylaxis - adult | 18% | 305 | 292 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.8% | 121 | 119 | $553.00 |
| D0330 | Panoramic radiographic image | 5.5% | 112 | 112 | $450.28 |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 13 | 13 | $0.00 |
| D0210 | Intraoral - complete series of radiographic images | 0% | 29 | 27 | $0.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 0% | 27 | 26 | $0.00 |
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 officialBELEN, MARIA (DENTIST)