Dental
A Miracle Smile By DR. Dezham Dental Group
A Miracle Smile By DR. Dezham Dental Group was paid $1.60M by Medicaid between Jan 2018 and Feb 2023, across 24 billing codes. Its largest line is D0120, dental checkup, returning patient — 12% of everything it billed.
33Billing provider infoA MIRACLE SMILE BY DR. DEZHAM DENTAL GROUP
SACRAMENTO, CA 95816
SACRAMENTO, CA 95816
33aNPI1770775447assigned 08/15/2007
33bProvider typeDentist
28Total paid$1.60M
24GClaims79,219
24DCodes billed24
24AFirst – last monthJan 2018 – Feb 2023
Compared with peers
Next to other Dentist providers in California
Rank by total paid#343 of 2,314
Median peer was paid$185K
This provider vs. median8.6×
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 | 18,554 | $240K | |
| 2019 | 16,788 | $239K | |
| 2020 | 9,542 | $174K | |
| 2021 | 15,510 | $334K | |
| 2022 | 17,186 | $544K | |
| 2023 | 1,639 | $73K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 6,761 | 6,606 | $190K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 6,875 | 6,721 | $186K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 4,512 | 2,118 | $178K |
| D1208 | Topical application of fluoride, excluding varnish | 9.4% | 7,852 | 7,683 | $151K |
| D1351 | Sealant - per tooth | 9.0% | 7,198 | 1,678 | $144K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.7% | 20,404 | 8,364 | $107K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 6.6% | 2,157 | 1,115 | $106K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.5% | 2,430 | 2,374 | $88K |
| D1110 | Prophylaxis - adult | 5.0% | 1,400 | 1,369 | $80K |
| D2751 | Crown - porcelain fused to predominantly base metal | 4.7% | 178 | 134 | $75K |
| D0220 | Intraoral - periapical first radiographic image | 4.6% | 8,993 | 8,650 | $73K |
| D9430 | 2.7% | 2,587 | 2,464 | $43K |
12 more codes
| D0274 | Bitewings - four radiographic images | 2.6% | 3,803 | $42K |
| D9999 | Unspecified adjunctive procedure, by report | 2.2% | 392 | $35K |
| D0210 | Intraoral - complete series of radiographic images | 2.0% | 1,534 | $32K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.8% | 1,102 | $28K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 176 | $12K |
| D2332 | <1% | 187 | $8K | |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 108 | $6K |
| D2954 | <1% | 103 | $6K | |
| D4341 | <1% | 168 | $5K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 144 | $4K |
| D1999 | <1% | 138 | $2K | |
| D4910 | <1% | 17 | $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 officialDEZHAM, HASSAN (OWNER)