Clinic
Shoe City Family Dental PC
Shoe City Family Dental PC was paid $138K by Medicaid between Aug 2021 and Dec 2024, across 11 billing codes. Its largest line is D1110, Prophylaxis - adult — 33% of everything it billed.
33Billing provider infoSHOE CITY FAMILY DENTAL PC
HAVERHILL, MA 01830
HAVERHILL, MA 01830
33aNPI1487267282assigned 08/31/2020
33bProvider typeDental Clinic/Center
28Total paid$138K
24GClaims2,972
24DCodes billed11
24AFirst – last monthAug 2021 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Massachusetts
Rank by total paid#179 of 307
Median peer was paid$245K
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 | |
|---|---|---|---|
| 2021 | 50 | $2K | |
| 2022 | 656 | $28K | |
| 2023 | 990 | $56K | |
| 2024incomplete | 1,276 | $52K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 33% | 806 | 793 | $46K |
| D0274 | Bitewings - four radiographic images | 18% | 819 | 805 | $24K |
| D2740 | Crown - porcelain/ceramic | 12% | 22 | 12 | $16K |
| D0330 | Panoramic radiographic image | 12% | 274 | 268 | $16K |
| D0150 | Comprehensive oral evaluation - new or established patient | 10% | 326 | 318 | $14K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.6% | 478 | 472 | $12K |
| D1208 | Topical application of fluoride, excluding varnish | 2.8% | 125 | 125 | $4K |
| D2950 | 1.9% | 17 | 13 | $3K | |
| D1120 | Dental cleaning, childProphylaxis - child | 1.0% | 26 | 26 | $1K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 65 | 64 | $967.00 |
| D0140 | Limited oral evaluation - problem focused | <1% | 14 | 14 | $442.00 |
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 officialKIM, DONG (OWNER)
| Provider | Location | Paid |
|---|---|---|
| DR. Dongwon Kim PC | Taunton, MA | $1.53M |
| DR. Dongwon Kim PC | Mattapan, MA | $1.22M |
| Quabbin Valley Dental PC | Athol, MA | $1.01M |
| Rockport Family Dental PC | Rockport, MA | $92K |
| Salem Family Dental Care, P.C. | Salem, MA | $83K |
| Dong S Kim DMD, PC | Lutherville, MD | $67K |
| Pine Dental PC | Fitchburg, MA | $16K |
| Lee and Kim Dental Corporation | Artesia, CA | $10K |
| Dong S. Kim, M.D., INC | Moreno Valley, CA | $1K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.