Riverdale Kidds Pediatric Dentistry, PLLC

Riverdale Kidds Pediatric Dentistry, PLLC was paid $58K by Medicaid between Apr 2019 and Nov 2024, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 41% of everything it billed.

33Billing provider infoRIVERDALE KIDDS PEDIATRIC DENTISTRY, PLLC
COON RAPIDS, MN 55433

33aNPI1477025906assigned 12/21/2018

33bProvider typePediatric Dentist

28Total paid$58K

24GClaims2,704

24DCodes billed5

24AFirst – last monthApr 2019 – Nov 2024

Compared with peers

Next to other Pediatric Dentist providers in Minnesota

Rank by total paid#27 of 49

Median peer was paid$94K

This provider vs. median0.6×

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
2019	565	$10K
2020	430	$7K
2021	538	$9K
2022	554	$15K
2023	441	$12K
2024incomplete	176	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	41%	995	966	$23K
D1206	Topical application of fluoride varnish	30%	937	908	$17K
D1120	Dental cleaning, childProphylaxis - child	29%	735	711	$16K
D0272	Bitewings - two radiographic images	<1%	25	24	$533.64
D0220	Intraoral - periapical first radiographic image	<1%	12	12	$164.40

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 officialCARLSON, DEANN (FINANCIAL COORDINATOR)