Dental
Jack M. Dorkhom, DMD, PLLC
Jack M. Dorkhom, DMD, PLLC was paid $21K by Medicaid between Oct 2019 and Oct 2024, across 2 billing codes. Its largest line is D1110, Prophylaxis - adult — 74% of everything it billed.
33Billing provider infoJACK M. DORKHOM, DMD, PLLC
PITTSFORD, NY 14534
PITTSFORD, NY 14534
33aNPI1659721025assigned 06/16/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$21K
24GClaims520
24DCodes billed2
24AFirst – last monthOct 2019 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in New York
Rank by total paid#1,389 of 2,184
Median peer was paid$54K
This provider vs. median0.4×
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 | 28 | $0.00 | |
| 2020 | 168 | $4K | |
| 2021 | 90 | $5K | |
| 2022 | 83 | $4K | |
| 2023 | 90 | $5K | |
| 2024incomplete | 61 | $4K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 74% | 291 | 290 | $16K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 26% | 229 | 229 | $5K |
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 officialDORKHOM, JACK (MEMBER/OWNER)