West Jordan Modern Dentistry , LLP

West Jordan Modern Dentistry , LLP was paid $4K by Medicaid between Jan 2018 and Jun 2018, across 5 billing codes. Its largest line is D0272, Bitewings - two radiographic images — 60% of everything it billed.

33Billing provider infoWEST JORDAN MODERN DENTISTRY , LLP
WEST JORDAN, UT 84084

33aNPI1508134412assigned 12/06/2011

33bProvider typeGeneral Practice Dentistry

28Total paid$4K

24GClaims251

24DCodes billed5

24AFirst – last monthJan 2018 – Jun 2018

Compared with peers

Next to other General Practice Dentistry providers in Utah

Rank by total paid#157 of 225

Median peer was paid$21K

This provider vs. median0.2×

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	251	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0272	Bitewings - two radiographic images	60%	33	33	$2K
D1120	Dental cleaning, childProphylaxis - child	37%	68	68	$1K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	2.9%	34	33	$111.88
D1330		0%	50	50	$0.00
D1206	Topical application of fluoride varnish	0%	66	66	$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 officialGOODELL, CHRISTINE (OWNER)