Dental
Port Pediatric Dentistry PC
Port Pediatric Dentistry PC was paid $379K by Medicaid between Jul 2020 and Dec 2024, across 14 billing codes. Its largest line is D1120, dental cleaning, child — 30% of everything it billed.
33Billing provider infoPORT PEDIATRIC DENTISTRY PC
HOLLAND, MI 49424
HOLLAND, MI 49424
33aNPI1669080651assigned 07/16/2020
33bProvider typePediatric Dentist
28Total paid$379K
24GClaims12,655
24DCodes billed14
24AFirst – last monthJul 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#83 of 153
Median peer was paid$464K
This provider vs. median0.8×
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 | 1,266 | $39K | |
| 2021 | 2,669 | $81K | |
| 2022 | 3,149 | $97K | |
| 2023 | 2,988 | $86K | |
| 2024incomplete | 2,583 | $76K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 30% | 3,247 | 3,245 | $115K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 26% | 3,519 | 3,517 | $100K |
| D0272 | Bitewings - two radiographic images | 9.1% | 2,213 | 2,211 | $34K |
| D1110 | Prophylaxis - adult | 7.0% | 568 | 568 | $26K |
| D1208 | Topical application of fluoride, excluding varnish | 5.8% | 1,000 | 998 | $22K |
| D1351 | Sealant - per tooth | 5.7% | 760 | 219 | $21K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.5% | 155 | 95 | $17K |
| D1206 | Topical application of fluoride varnish | 4.3% | 695 | 694 | $16K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.6% | 56 | 12 | $10K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.5% | 166 | 166 | $10K |
| D0274 | Bitewings - four radiographic images | 1.2% | 222 | 222 | $5K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 17 | 12 | $1K |
2 more codes
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 officialPORT, SUZANNE (DENTIST/OWNER)