Jackson Boulevard Dental Associates

Jackson Boulevard Dental Associates was paid $369.72 by Medicaid between Jul 2019 and Jul 2019, across 1 billing code. Its largest line is D0120, dental checkup, returning patient — 100% of everything it billed.

33Billing provider infoJACKSON BOULEVARD DENTAL ASSOCIATES
RAPID CITY, SD 57702

33aNPI1629315932assigned 01/07/2013

33bProvider typeDentist

28Total paid$369.72

24GClaims13

24DCodes billed1

24AFirst – last monthJul 2019 – Jul 2019

Compared with peers

Next to other Dentist providers in South Dakota

Rank by total paid#42 of 42

Median peer was paid$19K

This provider vs. median0.0×

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
2019	13	$369.72

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	100%	13	13	$369.72

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 officialTAYLOR, JARED (OWNER)