Dental
San Bruno Ave Dental Clinic Corp
San Bruno Ave Dental Clinic Corp was paid $6K by Medicaid between Feb 2023 and Sep 2024, across 6 billing codes. Its largest line is D0230, Intraoral - periapical each additional radiographic image — 26% of everything it billed.
33Billing provider infoSAN BRUNO AVE DENTAL CLINIC CORP
SAN FRANCISCO, CA 94134
SAN FRANCISCO, CA 94134
33aNPI1639228950assigned 01/09/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$6K
24GClaims848
24DCodes billed6
24AFirst – last monthFeb 2023 – Sep 2024
Compared with peers
Next to other General Practice Dentistry providers in California
Rank by total paid#2,272 of 2,668
Median peer was paid$173K
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 | |
|---|---|---|---|
| 2023 | 528 | $3K | |
| 2024incomplete | 320 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0230 | Intraoral - periapical each additional radiographic image | 26% | 563 | 110 | $2K |
| D4910 | 22% | 26 | 26 | $1K | |
| D1208 | Topical application of fluoride, excluding varnish | 21% | 151 | 151 | $1K |
| D0274 | Bitewings - four radiographic images | 19% | 67 | 67 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 10% | 26 | 26 | $650.00 |
| D0220 | Intraoral - periapical first radiographic image | 2.3% | 15 | 15 | $150.00 |
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 officialTIN, JUSTIN (SENIOR DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Tin Dental Specialty Group a Professional Dental Corp | San Leandro, CA | $5.21M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.