Dental
Dental 360 Kenosha
Dental 360 Kenosha was paid $199K by Medicaid between Mar 2023 and Dec 2024, across 15 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 43% of everything it billed.
33Billing provider infoDENTAL 360 KENOSHA
KENOSHA, WI 53142
KENOSHA, WI 53142
33aNPI1669199600assigned 10/20/2022
33bProvider typeGeneral Practice Dentistry
28Total paid$199K
24GClaims5,080
24DCodes billed15
24AFirst – last monthMar 2023 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Wisconsin
Rank by total paid#60 of 208
Median peer was paid$26K
This provider vs. median7.7×
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 | 1,006 | $41K | |
| 2024incomplete | 4,074 | $158K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 43% | 866 | 262 | $86K |
| D0330 | Panoramic radiographic image | 19% | 819 | 776 | $37K |
| D0140 | Limited oral evaluation - problem focused | 8.2% | 784 | 720 | $16K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.8% | 631 | 601 | $15K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.1% | 261 | 109 | $12K |
| D1110 | Prophylaxis - adult | 4.6% | 306 | 288 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 3.3% | 771 | 670 | $7K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.2% | 94 | 60 | $6K |
| D1208 | Topical application of fluoride, excluding varnish | 1.3% | 149 | 148 | $3K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.0% | 30 | 12 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.0% | 67 | 67 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 71 | 70 | $1K |
3 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 officialBUENO, IVANA (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Dental 360 Oak Creek LLC | Oak Creek, WI | $73K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.