Dental
Modern Dental Specialist, LLC
Modern Dental Specialist, LLC was paid $16K by Medicaid between Sep 2024 and Dec 2024, across 8 billing codes. Its largest line is D0330, Panoramic radiographic image — 27% of everything it billed.
33Billing provider infoMODERN DENTAL SPECIALIST, LLC
LAS VEGAS, NV 89109
LAS VEGAS, NV 89109
33aNPI1487344032assigned 05/08/2023
33bProvider typePeriodontist
28Total paid$16K
24GClaims771
24DCodes billed8
24AFirst – last monthSep 2024 – Dec 2024
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 | |
|---|---|---|---|
| 2024incomplete | 771 | $16K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 27% | 117 | 109 | $4K |
| D0274 | Bitewings - four radiographic images | 20% | 140 | 130 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 19% | 126 | 119 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 13% | 163 | 151 | $2K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 12% | 30 | 12 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.9% | 169 | 148 | $959.45 |
| D1206 | Topical application of fluoride varnish | 2.9% | 14 | 14 | $477.75 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.6% | 12 | 12 | $262.50 |
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 officialSAVCIC, ANASTASIA (HR)
Parent organizationMODERN DENTAL SPECIALISTS, LLC
| Provider | Location | Paid |
|---|---|---|
| Modern Dental Specialist, LLC | Las Vegas, NV | $94K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.