NP / PA
Pacific Dental Services Foundation
Pacific Dental Services Foundation was paid $3K by Medicaid between Feb 2020 and Oct 2024, across 16 billing codes. Its largest line is D1120, dental cleaning, child — 25% of everything it billed.
33Billing provider infoPACIFIC DENTAL SERVICES FOUNDATION
PHOENIX, AZ 85032
PHOENIX, AZ 85032
33aNPI1659848208assigned 10/31/2018
33bProvider typeMedical Physician Assistant
28Total paid$3K
24GClaims8,245
24DCodes billed16
24AFirst – last monthFeb 2020 – Oct 2024
Compared with peers
Next to other Medical Physician Assistant providers in Arizona
Rank by total paid#25 of 32
Median peer was paid$16K
This provider vs. median0.2×
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 | 30 | $39.00 | |
| 2021 | 2,630 | $1K | |
| 2022 | 2,914 | $1K | |
| 2023 | 1,439 | $462.90 | |
| 2024incomplete | 1,232 | $394.11 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 662 | 646 | $879.66 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 19% | 1,043 | 1,005 | $672.87 |
| D1206 | Topical application of fluoride varnish | 19% | 1,485 | 1,427 | $652.89 |
| D1110 | Prophylaxis - adult | 13% | 647 | 608 | $452.31 |
| D0220 | Intraoral - periapical first radiographic image | 7.9% | 824 | 786 | $274.48 |
| D0230 | Intraoral - periapical each additional radiographic image | 6.1% | 719 | 677 | $211.69 |
| D0274 | Bitewings - four radiographic images | 4.5% | 340 | 323 | $156.70 |
| D0140 | Limited oral evaluation - problem focused | 2.3% | 26 | 26 | $78.72 |
| D0330 | Panoramic radiographic image | 1.3% | 12 | 12 | $45.18 |
| D0272 | Bitewings - two radiographic images | <1% | 51 | 51 | $24.14 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 49 | 44 | $22.91 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 127 | 122 | $0.00 |
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 officialDILLENBERG, JACK (OWNER)