Dental
San Pedro Dental
San Pedro Dental was paid $419K by Medicaid between Jan 2018 and Dec 2024, across 18 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 19% of everything it billed.
33Billing provider infoSAN PEDRO DENTAL
SAN PEDRO, CA 90731
SAN PEDRO, CA 90731
33aNPI1538451208assigned 05/12/2011
33bProvider typeDentist
28Total paid$419K
24GClaims18,501
24DCodes billed18
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in California
Rank by total paid#847 of 2,314
Median peer was paid$185K
This provider vs. median2.3×
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 | 4,284 | $95K | |
| 2019 | 3,202 | $72K | |
| 2020 | 4,191 | $95K | |
| 2021 | 4,687 | $109K | |
| 2022 | 1,356 | $35K | |
| 2023 | 372 | $5K | |
| 2024incomplete | 409 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 19% | 1,261 | 663 | $81K |
| D0150 | Comprehensive oral evaluation - new or established patient | 18% | 1,413 | 1,402 | $75K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 1,438 | 1,432 | $60K |
| D0210 | Intraoral - complete series of radiographic images | 8.6% | 983 | 972 | $36K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.2% | 1,163 | 1,149 | $34K |
| D0230 | Intraoral - periapical each additional radiographic image | 8.0% | 7,460 | 1,699 | $33K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.3% | 417 | 234 | $22K |
| D1208 | Topical application of fluoride, excluding varnish | 4.6% | 1,626 | 1,608 | $19K |
| D7140 | Extraction, erupted tooth or exposed root | 4.6% | 338 | 154 | $19K |
| D0274 | Bitewings - four radiographic images | 3.9% | 924 | 921 | $16K |
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 1,187 | 1,163 | $9K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 1.5% | 52 | 29 | $6K |
6 more codes
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 officialFRY, SPEED (MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Martinez Dental Office | Los Angeles, CA | $97K |
| Torrance Family Dental | Torrance, CA | $55K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.