Dental
Pacific Smile Dental Clinic
Pacific Smile Dental Clinic was paid $872K by Medicaid between Jan 2018 and Dec 2024, across 21 billing codes. Its largest line is D2740, Crown - porcelain/ceramic — 18% of everything it billed.
33Billing provider infoPACIFIC SMILE DENTAL CLINIC
LA HABRA, CA 90631
LA HABRA, CA 90631
33aNPI1528220977assigned 06/26/2008
33bProvider typeDentist
28Total paid$872K
24GClaims23,742
24DCodes billed21
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in California
Rank by total paid#555 of 2,314
Median peer was paid$185K
This provider vs. median4.7×
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 | 1,409 | $27K | |
| 2019 | 2,507 | $56K | |
| 2020 | 1,520 | $40K | |
| 2021 | 2,499 | $72K | |
| 2022 | 4,331 | $144K | |
| 2023 | 5,193 | $228K | |
| 2024incomplete | 6,283 | $305K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2740 | Crown - porcelain/ceramic | 18% | 339 | 270 | $161K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14% | 1,904 | 1,891 | $122K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 1,367 | 1,353 | $91K |
| D0210 | Intraoral - complete series of radiographic images | 9.5% | 1,778 | 1,773 | $83K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 9.1% | 1,464 | 705 | $79K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.0% | 1,192 | 687 | $79K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.0% | 1,080 | 1,068 | $44K |
| D4341 | 4.5% | 565 | 150 | $39K | |
| D0230 | Intraoral - periapical each additional radiographic image | 4.1% | 8,682 | 1,866 | $36K |
| D1110 | Prophylaxis - adult | 2.8% | 285 | 285 | $25K |
| D2954 | 2.6% | 216 | 177 | $23K | |
| D1208 | Topical application of fluoride, excluding varnish | 2.5% | 1,718 | 1,705 | $22K |
9 more codes
| D0350 | 1.5% | 1,419 | $13K | |
| D9430 | 1.4% | 379 | $12K | |
| D4910 | 1.2% | 136 | $10K | |
| D0272 | Bitewings - two radiographic images | <1% | 702 | $8K |
| D0274 | Bitewings - four radiographic images | <1% | 392 | $8K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 66 | $8K |
| D2751 | Crown - porcelain fused to predominantly base metal | <1% | 14 | $7K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 20 | $1K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 24 | $276.00 |
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 officialALANIZ, ROBERTO (DENTIST)