Dental
Fairwood Dental LLC
Fairwood Dental LLC was paid $1.20M by Medicaid between Aug 2020 and Dec 2024, across 22 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 27% of everything it billed.
33Billing provider infoFAIRWOOD DENTAL LLC
RENTON, WA 98058
RENTON, WA 98058
33aNPI1639799471assigned 04/22/2020
33bProvider typeGeneral Practice Dentistry
28Total paid$1.20M
24GClaims32,360
24DCodes billed22
24AFirst – last monthAug 2020 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Washington
Rank by total paid#46 of 319
Median peer was paid$22K
This provider vs. median56×
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 | |
|---|---|---|---|
| 2020 | 4,097 | $87K | |
| 2021 | 6,681 | $193K | |
| 2022 | 5,371 | $254K | |
| 2023 | 8,343 | $377K | |
| 2024incomplete | 7,868 | $292K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 27% | 4,699 | 1,876 | $324K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 18% | 2,120 | 1,108 | $212K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.9% | 3,309 | 2,958 | $120K |
| D0210 | Intraoral - complete series of radiographic images | 9.9% | 3,046 | 2,723 | $120K |
| D1110 | Prophylaxis - adult | 8.3% | 2,080 | 1,874 | $100K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.1% | 1,234 | 587 | $61K |
| D0140 | Limited oral evaluation - problem focused | 4.3% | 1,753 | 1,580 | $51K |
| D1206 | Topical application of fluoride varnish | 3.7% | 2,253 | 2,019 | $45K |
| D4341 | 2.7% | 892 | 344 | $33K | |
| D0220 | Intraoral - periapical first radiographic image | 2.6% | 3,262 | 2,794 | $31K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.9% | 730 | 646 | $23K |
| D7140 | Extraction, erupted tooth or exposed root | 1.5% | 479 | 141 | $18K |
10 more codes
| D0274 | Bitewings - four radiographic images | 1.1% | 1,013 | $14K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 1.1% | 142 | $13K |
| D2394 | <1% | 93 | $10K | |
| D1999 | <1% | 1,357 | $9K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 3,132 | $7K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 466 | $5K |
| D2331 | <1% | 42 | $4K | |
| D1351 | Sealant - per tooth | <1% | 214 | $3K |
| D2330 | <1% | 32 | $1K | |
| D1120 | Dental cleaning, child | <1% | 12 | $275.76 |
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 officialPROBST, TRAVIS (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Bonney Lake Dental LLC | Bonney Lake, WA | $4.81M |
| Fairwood Pedodonticsllc | Renton, WA | $1.33M |
| Lake Meridian Dental LLC | Kent, WA | $435K |
| Puyallup Dental, LLC | Puyallup, WA | $84K |
| North Lakewood Dental PLCC | Lakewood, WA | $30K |
| Port Orchard Dental LLC | Port Orchard, WA | $7K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.