Dental
Great Smile Dental PLLC
Great Smile Dental PLLC was paid $274K by Medicaid between Oct 2020 and May 2022, across 21 billing codes. Its largest line is D0140, Limited oral evaluation - problem focused — 14% of everything it billed.
33Billing provider infoGREAT SMILE DENTAL PLLC
LAS VEGAS, NV 89147
LAS VEGAS, NV 89147
33aNPI1568071827assigned 07/23/2020
33bProvider typePublic Health Dentist
28Total paid$274K
24GClaims16,135
24DCodes billed21
24AFirst – last monthOct 2020 – May 2022
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 | |
|---|---|---|---|
| 2020 | 3,145 | $36K | |
| 2021 | 10,746 | $198K | |
| 2022 | 2,244 | $39K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 14% | 1,620 | 1,368 | $39K |
| D0274 | Bitewings - four radiographic images | 12% | 1,805 | 1,543 | $32K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 11% | 944 | 246 | $31K |
| D0330 | Panoramic radiographic image | 10% | 1,004 | 852 | $29K |
| D1120 | Dental cleaning, childProphylaxis - child | 10% | 774 | 693 | $28K |
| D0220 | Intraoral - periapical first radiographic image | 8.8% | 2,399 | 2,030 | $24K |
| D1206 | Topical application of fluoride varnish | 8.0% | 965 | 852 | $22K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.0% | 3,350 | 1,934 | $16K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.4% | 650 | 584 | $12K |
| D1351 | Sealant - per tooth | 3.7% | 533 | 70 | $10K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.9% | 236 | 84 | $8K |
| D1110 | Prophylaxis - adult | 2.8% | 536 | 437 | $8K |
9 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 2.7% | 271 | $7K |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 72 | $2K |
| D0602 | <1% | 394 | $2K | |
| D9999 | Unspecified adjunctive procedure, by report | <1% | 72 | $1K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 23 | $1K |
| D0270 | <1% | 71 | $601.29 | |
| D9110 | <1% | 27 | $442.00 | |
| D1999 | 0% | 294 | $0.00 | |
| D0350 | 0% | 95 | $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 officialMORALES, JACQUELINE (DISTRICT MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Crown of Life NY LLC | Brooklyn, NY | $67.67M |
| Great Smile Dental PLLC | Deerfield, IL | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.