Stansbury Park Pediatric Dentistry

Stansbury Park Pediatric Dentistry was paid $7K by Medicaid between Feb 2020 and Aug 2022, across 5 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 49% of everything it billed.

33Billing provider infoSTANSBURY PARK PEDIATRIC DENTISTRY
STANSBURY PARK, UT 84074

33aNPI1487295218assigned 10/02/2019

33bProvider typePediatric Dentist

28Total paid$7K

24GClaims257

24DCodes billed5

24AFirst – last monthFeb 2020 – Aug 2022

Compared with peers

Next to other Pediatric Dentist providers in Utah

Rank by total paid#141 of 152

Median peer was paid$311K

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
2020	57	$3K
2021	12	$77.94
2022	188	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	49%	24	24	$3K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	33%	12	12	$2K
D0272	Bitewings - two radiographic images	13%	56	55	$867.44
D1120	Dental cleaning, childProphylaxis - child	3.7%	98	98	$251.92
D1206	Topical application of fluoride varnish	1.6%	67	67	$104.83

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 officialSHIGLEY, ALISHA (OFFICE MANAGER)