Mona Lisa Smiles PLLC

Mona Lisa Smiles PLLC was paid $4K by Medicaid between Mar 2021 and Jun 2023, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 33% of everything it billed.

33Billing provider infoMONA LISA SMILES PLLC
BEE CAVE, TX 78738

33aNPI1447758701assigned 01/31/2018

33bProvider typeOrthodontics and Dentofacial Orthopedic Dentist

28Total paid$4K

24GClaims341

24DCodes billed5

24AFirst – last monthMar 2021 – Jun 2023

Compared with peers

Next to other Orthodontics and Dentofacial Orthopedic Dentist providers in Texas

Rank by total paid#70 of 87

Median peer was paid$54K

This provider vs. median0.1×

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
2021	193	$2K
2022	72	$349.86
2023	76	$989.33

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	33%	47	42	$1K
D1206	Topical application of fluoride varnish	31%	88	82	$1K
D1120	Dental cleaning, childProphylaxis - child	27%	27	27	$988.58
D0272	Bitewings - two radiographic images	8.9%	14	14	$327.32
D0603		0%	165	135	$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 officialREZAPOUR, MONA (DOCTOR/OWNER)