Dental
Ashburnfarm Dental Arts
Ashburnfarm Dental Arts was paid $1K by Medicaid between Sep 2021 and Nov 2023, across 2 billing codes. Its largest line is D1110, Prophylaxis - adult — 54% of everything it billed.
33Billing provider infoASHBURNFARM DENTAL ARTS
ASHBURN, VA 20147
ASHBURN, VA 20147
33aNPI1487054128assigned 08/31/2014
33bProvider typeAdvanced Practice Dental Therapist
28Total paid$1K
24GClaims82
24DCodes billed2
24AFirst – last monthSep 2021 – Nov 2023
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 | 15 | $302.25 | |
| 2022 | 28 | $933.04 | |
| 2023 | 39 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 54% | 40 | 40 | $671.09 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 46% | 42 | 42 | $564.20 |
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 officialASHOURIPOUR, DAN (PRESIDENT)
Parent organizationLANDMARK SMILE DDS PC