Dental
Port Orchard Dental LLC
Port Orchard Dental LLC was paid $7K by Medicaid between Nov 2021 and Jan 2022, across 5 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 50% of everything it billed.
33Billing provider infoPORT ORCHARD DENTAL LLC
PORT ORCHARD, WA 98366
PORT ORCHARD, WA 98366
33aNPI1538732144assigned 07/21/2021
33bProvider typeDentist
28Total paid$7K
24GClaims298
24DCodes billed5
24AFirst – last monthNov 2021 – Jan 2022
Compared with peers
Next to other Dentist providers in Washington
Rank by total paid#219 of 335
Median peer was paid$30K
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 | |
|---|---|---|---|
| 2021 | 223 | $5K | |
| 2022 | 75 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 50% | 114 | 85 | $3K |
| D0140 | Limited oral evaluation - problem focused | 23% | 50 | 47 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 19% | 45 | 26 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 7.3% | 50 | 48 | $502.24 |
| D0230 | Intraoral - periapical each additional radiographic image | 1.3% | 39 | 25 | $90.75 |
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 officialPROBST, TRAVIS (DENTIST/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Bonney Lake Dental LLC | Bonney Lake, WA | $4.81M |
| Fairwood Pedodonticsllc | Renton, WA | $1.33M |
| Fairwood Dental LLC | Renton, WA | $1.20M |
| Lake Meridian Dental LLC | Kent, WA | $435K |
| Puyallup Dental, LLC | Puyallup, WA | $84K |
| North Lakewood Dental PLCC | Lakewood, WA | $30K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.