Lakeshore Family Dentistry PA

Lakeshore Family Dentistry PA was paid $521.73 by Medicaid between Aug 2019 and Sep 2020, across 2 billing codes. Its largest line is D0120, dental checkup, returning patient — 100% of everything it billed.

33Billing provider infoLAKESHORE FAMILY DENTISTRY PA
WHITE BEAR LAKE, MN 55110

33aNPI1669585154assigned 08/17/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$521.73

24GClaims42

24DCodes billed2

24AFirst – last monthAug 2019 – Sep 2020

Compared with peers

Next to other General Practice Dentistry providers in Minnesota

Rank by total paid#308 of 368

Median peer was paid$19K

This provider vs. median0.0×

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
2019	12	$263.34
2020	30	$258.39

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	100%	26	26	$521.73
D9985		0%	16	14	$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 officialDELGRECO, JONNI (OFFICE MANAGER)