Dental
Shine Pediatric Dental Co.
Shine Pediatric Dental Co. was paid $42K by Medicaid between Nov 2023 and Dec 2024, across 11 billing codes. Its largest line is D0145, Oral evaluation for a patient under three years of age — 21% of everything it billed.
33Billing provider infoSHINE PEDIATRIC DENTAL CO.
ROUND ROCK, TX 78664
ROUND ROCK, TX 78664
33aNPI1548977895assigned 11/04/2022
33bProvider typePediatric Dentist
28Total paid$42K
24GClaims2,605
24DCodes billed11
24AFirst – last monthNov 2023 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#488 of 693
Median peer was paid$252K
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 | |
|---|---|---|---|
| 2023 | 183 | $2K | |
| 2024incomplete | 2,422 | $40K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0145 | Oral evaluation for a patient under three years of age | 21% | 81 | 77 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 238 | 222 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 154 | 145 | $5K |
| D1351 | Sealant - per tooth | 11% | 169 | 29 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 11% | 522 | 228 | $5K |
| D0272 | Bitewings - two radiographic images | 8.2% | 171 | 161 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 6.8% | 277 | 258 | $3K |
| D1206 | Topical application of fluoride varnish | 6.4% | 209 | 201 | $3K |
| D0350 | 5.5% | 237 | 224 | $2K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.4% | 42 | 41 | $1K |
| D0603 | 0% | 505 | 480 | $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 officialSEVERSON, SARAH (OWNER)