NEVADA DENTAL TEAM PLLC

NPI: 1528646569 · LAS VEGAS, NV 89119 · Dentist · NPI assigned 03/31/2021

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official LARSEN, DEVIN controls 20+ related entities in our dataset. Read more

$205K

Total Medicaid Paid

5,206

Total Claims

3,515

Beneficiaries

Codes Billed

2022-11

First Month

2024-12

Last Month

Provider Details

Authorized Official	LARSEN, DEVIN (CEO)
NPI Enumeration Date	03/31/2021

Other providers sharing the same authorized official: LARSEN, DEVIN

Provider	City	State	Total Paid
VALLARINE DENTAL CORPORATION	FRESNO	CA	$38.23M
COFFEE SURGERY CENTER, LLC	BAKERSFIELD	CA	$14.86M
KC CHILDRENS SURGERY CENTER LLC	KANSAS CITY	KS	$13.76M
HOUSTON CHILDREN'S DENTAL CENTER, LLC	HOUSTON	TX	$11.03M
DENTAL SURGICENTER OF LOUISVILLE LLC	LOUISVILLE	KY	$8.44M
DENTAL SURGERY CENTERS OF AMERICA	ATWATER	CA	$7.22M
DENTAL SURGERY CENTERS OF AMERICA	STOCKTON	CA	$6.82M
JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC	JACKSONVILLE	FL	$6.31M
MEDICAL AND DENTAL CENTER OF NEVADA LLC	LAS VEGAS	NV	$6.00M
SAN ANTONIO CHILDRENS SURGICAL	SAN ANTONIO	TX	$4.91M
CHILDREN 1ST HOUSTON SOUTH, LLC	HOUSTON	TX	$3.69M
FORT MYERS CHILDREN'S SURGERY CENTER, LLC	FT MYERS	FL	$3.42M
VISALIA CHILDREN'S DENTAL SURGERY CENTER INC	VISALIA	CA	$3.35M
CHILDREN 1ST GRAND PRAIRIE, LLC	GRAND PRAIRIE	TX	$3.31M
DENTAL SURGERY CENTERS OF AMERICA	SANTA MARIA	CA	$2.66M
WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC	PALM SPRINGS	FL	$1.63M
BLUE CLOUD ANESTHESIA, LLC	TAMPA	FL	$1.57M
SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC	RALEIGH	NC	$1.38M
BLUE CLOUD ANESTHESIA, LLC	ORLANDO	FL	$1.36M
DENTAL SURGICENTER OF LOUISVILLE LLC	LOUISVILLE	KY	$965K

Code	Description	Claims	Beneficiaries	Total Paid
D2930	Prefabricated stainless steel crown - primary tooth	944	194	$88K
D2929		223	68	$29K
D0140	Limited oral evaluation - problem focused	809	786	$26K
D7140	Extraction, erupted tooth or exposed root	331	106	$15K
D0150	Comprehensive oral evaluation - new or established patient	450	435	$14K
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	197	74	$13K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	127	41	$6K
D0272	Bitewings - two radiographic images	324	319	$4K
D0230	Intraoral - periapical each additional radiographic image	624	382	$3K
D0603		792	769	$3K
D9310		28	28	$2K
D0220	Intraoral - periapical first radiographic image	160	145	$1K
D1206	Topical application of fluoride varnish	78	65	$954.30
D0240		57	44	$712.80
D1120	Prophylaxis - child	31	29	$515.52
D9610		19	18	$383.97
D9420		12	12	$81.98