Clinic
Main Street Dental, PLLC
Main Street Dental, PLLC was paid $18K by Medicaid between May 2018 and Jun 2020, across 7 billing codes. Its largest line is D0120, dental checkup, returning patient — 29% of everything it billed.
33Billing provider infoMAIN STREET DENTAL, PLLC
LOCUST GROVE, OK 74352
LOCUST GROVE, OK 74352
33aNPI1679072664assigned 02/06/2018
33bProvider typeDental Clinic/Center
28Total paid$18K
24GClaims860
24DCodes billed7
24AFirst – last monthMay 2018 – Jun 2020
Compared with peers
Next to other Dental Clinic/Center providers in Oklahoma
Rank by total paid#79 of 112
Median peer was paid$86K
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 | |
|---|---|---|---|
| 2018 | 576 | $13K | |
| 2019 | 255 | $5K | |
| 2020 | 29 | $527.50 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 29% | 260 | 260 | $5K |
| D1206 | Topical application of fluoride varnish | 26% | 327 | 327 | $5K |
| D1120 | Dental cleaning, childProphylaxis - child | 24% | 150 | 150 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.5% | 21 | 12 | $1K |
| D1110 | Prophylaxis - adult | 6.5% | 28 | 28 | $1K |
| D0274 | Bitewings - four radiographic images | 6.0% | 38 | 38 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 2.7% | 36 | 36 | $497.77 |
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 officialHENRY, DAVID (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Santa Clarita Emergency Medical Group INC | Valencia, CA | $5.21M |
| Access Healthcare PC | Hartford, CT | $800K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.