Wayzata Dental, LTD.

Wayzata Dental, LTD. was paid $19K by Medicaid between Nov 2023 and Apr 2024, across 6 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 65% of everything it billed.

33Billing provider infoWAYZATA DENTAL, LTD.
WAYZATA, MN 55391

33aNPI1659554517assigned 12/13/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$19K

24GClaims289

24DCodes billed6

24AFirst – last monthNov 2023 – Apr 2024

Compared with peers

Next to other General Practice Dentistry providers in Minnesota

Rank by total paid#184 of 368

Median peer was paid$19K

This provider vs. median1.0×

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	13	$630.12
2024incomplete	276	$19K

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	65%	153	15	$13K
D2391	Resin-based composite - one surface, posterior, primary or permanent	17%	52	14	$3K
D1110	Prophylaxis - adult	7.9%	30	29	$2K
D0150	Comprehensive oral evaluation - new or established patient	4.9%	25	25	$940.27
D0274	Bitewings - four radiographic images	3.0%	17	17	$578.76
D1206	Topical application of fluoride varnish	1.6%	12	12	$304.92

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 officialMCDOWELL, JASON (OWNER)