Dental
Pediatric Dentistry of Portland LLC
Pediatric Dentistry of Portland LLC was paid $7K by Medicaid between Jan 2018 and Sep 2018, across 3 billing codes. Its largest line is D1120, dental cleaning, child — 39% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF PORTLAND LLC
PORTLAND, OR 97232
PORTLAND, OR 97232
33aNPI1679924526assigned 06/22/2016
33bProvider typePediatric Dentist
28Total paid$7K
24GClaims303
24DCodes billed3
24AFirst – last monthJan 2018 – Sep 2018
Compared with peers
Next to other Pediatric Dentist providers in Oregon
Rank by total paid#97 of 109
Median peer was paid$362K
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 | |
|---|---|---|---|
| 2018 | 303 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 39% | 73 | 73 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 32% | 146 | 146 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 29% | 84 | 84 | $2K |
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 officialLARSEN, NOEL (OWNER)