Dental
Pediatric Dentistry LTD
Pediatric Dentistry LTD was paid $1.47M by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 20% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY LTD
FARGO, ND 58103
FARGO, ND 58103
33aNPI1487882718assigned 06/25/2009
33bProvider typeDentist
28Total paid$1.47M
24GClaims27,291
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in North Dakota
Rank by total paid#2 of 33
Median peer was paid$14K
This provider vs. median102×
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 | |
|---|---|---|---|
| 2018 | 1,017 | $25K | |
| 2019 | 1,421 | $37K | |
| 2020 | 1,560 | $48K | |
| 2021 | 3,044 | $103K | |
| 2022 | 5,679 | $275K | |
| 2023 | 7,188 | $471K | |
| 2024incomplete | 7,382 | $515K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 20% | 1,592 | 268 | $292K |
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 4,823 | 4,567 | $238K |
| D1206 | Topical application of fluoride varnish | 13% | 6,850 | 6,495 | $197K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 5,101 | 4,915 | $183K |
| D9420 | 10% | 546 | 464 | $152K | |
| D7140 | Extraction, erupted tooth or exposed root | 7.0% | 948 | 251 | $104K |
| D0272 | Bitewings - two radiographic images | 5.8% | 2,602 | 2,458 | $85K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.6% | 1,053 | 1,004 | $68K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.2% | 671 | 587 | $32K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.6% | 128 | 65 | $24K |
| D0330 | Panoramic radiographic image | 1.6% | 286 | 275 | $23K |
| D0240 | 1.1% | 556 | 280 | $17K |
8 more codes
| D0230 | Intraoral - periapical each additional radiographic image | 1.1% | 829 | $16K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 622 | $13K |
| D1351 | Sealant - per tooth | <1% | 411 | $12K |
| D1110 | Prophylaxis - adult | <1% | 159 | $9K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 31 | $5K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 41 | $4K |
| D0140 | Limited oral evaluation - problem focused | <1% | 24 | $1K |
| D3120 | 0% | 18 | $0.00 |
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 officialOLSON, TRAVIS (PRESIDENT)