Montgomery Mall Dental, LLP

Montgomery Mall Dental, LLP was paid $1K by Medicaid between Aug 2018 and Dec 2020, across 3 billing codes. Its largest line is D1110, Prophylaxis - adult — 71% of everything it billed.

33Billing provider infoMONTGOMERY MALL DENTAL, LLP
NORTH WALES, PA 19454

33aNPI1770821761assigned 01/25/2013

33bProvider typeDentist

28Total paid$1K

24GClaims56

24DCodes billed3

24AFirst – last monthAug 2018 – Dec 2020

Compared with peers

Next to other Dentist providers in Pennsylvania

Rank by total paid#605 of 683

Median peer was paid$34K

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	18	$568.65
2020	38	$885.00

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	71%	31	30	$1K
D0274	Bitewings - four radiographic images	22%	12	12	$325.80
D0220	Intraoral - periapical first radiographic image	7.0%	13	13	$101.40

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 officialSHAAKOVA, VIKTORIYA (OFFICE MANAGER)