Dental
Divine Dental LLC
Divine Dental LLC was paid $928K by Medicaid between Mar 2018 and Dec 2024, across 18 billing codes. Its largest line is D7140, Extraction, erupted tooth or exposed root — 30% of everything it billed.
33Billing provider infoDIVINE DENTAL LLC
BALTIMORE, MD 21225
BALTIMORE, MD 21225
33aNPI1710299268assigned 07/12/2010
33bProvider typeGeneral Practice Dentistry
28Total paid$928K
24GClaims18,411
24DCodes billed18
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Maryland
Rank by total paid#60 of 598
Median peer was paid$42K
This provider vs. median22×
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 | 236 | $7K | |
| 2019 | 550 | $14K | |
| 2020 | 444 | $12K | |
| 2021 | 690 | $21K | |
| 2022 | 569 | $16K | |
| 2023 | 5,075 | $258K | |
| 2024incomplete | 10,847 | $601K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7140 | Extraction, erupted tooth or exposed root | 30% | 2,128 | 528 | $282K |
| D1110 | Prophylaxis - adult | 11% | 1,649 | 1,635 | $105K |
| D0330 | Panoramic radiographic image | 8.4% | 1,747 | 1,737 | $78K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.3% | 575 | 400 | $77K |
| D1206 | Topical application of fluoride varnish | 7.4% | 2,735 | 2,708 | $68K |
| D0140 | Limited oral evaluation - problem focused | 7.0% | 1,410 | 1,347 | $65K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.9% | 1,162 | 1,155 | $64K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.6% | 403 | 273 | $43K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.3% | 1,340 | 1,325 | $40K |
| D0274 | Bitewings - four radiographic images | 2.7% | 1,067 | 1,064 | $25K |
| D0220 | Intraoral - periapical first radiographic image | 2.5% | 2,047 | 1,931 | $23K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.2% | 119 | 94 | $20K |
6 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 officialDESROCHERS, MARYELLEN (OFFICE MANAGER)
Parent organizationDIVINE DENTAL LLC