Dental
Prince William Dental LLC
Prince William Dental LLC was paid $15K by Medicaid between Apr 2021 and Jul 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 28% of everything it billed.
33Billing provider infoPRINCE WILLIAM DENTAL LLC
GAINESVILLE, VA 20155
GAINESVILLE, VA 20155
33aNPI1609499151assigned 05/19/2020
33bProvider typeGeneral Practice Dentistry
28Total paid$15K
24GClaims465
24DCodes billed9
24AFirst – last monthApr 2021 – Jul 2024
Compared with peers
Next to other General Practice Dentistry providers in Virginia
Rank by total paid#329 of 549
Median peer was paid$29K
This provider vs. median0.5×
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 | 64 | $2K | |
| 2022 | 249 | $11K | |
| 2023 | 80 | $2K | |
| 2024incomplete | 72 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 28% | 87 | 86 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 20% | 32 | 13 | $3K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 157 | 156 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 15% | 80 | 71 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 13% | 27 | 27 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 2.5% | 42 | 42 | $363.25 |
| D1206 | Topical application of fluoride varnish | 2.2% | 12 | 12 | $324.36 |
| D0230 | Intraoral - periapical each additional radiographic image | 1.4% | 15 | 12 | $203.42 |
| D0274 | Bitewings - four radiographic images | 0% | 13 | 13 | $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 officialKASIPATHY, MADHUSUDHAN (DENTIST/ OWNER)