Clinic
Ne Specialty Dental Services LLC
Ne Specialty Dental Services LLC was paid $521K by Medicaid between Feb 2023 and Oct 2024, across 16 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 24% of everything it billed.
33Billing provider infoNE SPECIALTY DENTAL SERVICES LLC
OMAHA, NE 68164
OMAHA, NE 68164
33aNPI1790449247assigned 10/29/2021
33bProvider typeOral and Maxillofacial Surgery Clinic/Center
28Total paid$521K
24GClaims21,278
24DCodes billed16
24AFirst – last monthFeb 2023 – Oct 2024
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official DASCH, CHARLOTTE controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2023 | 15,009 | $369K | |
| 2024incomplete | 6,269 | $152K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 24% | 4,956 | 4,846 | $125K |
| D1120 | Dental cleaning, childProphylaxis - child | 24% | 4,421 | 4,332 | $124K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 20% | 4,288 | 4,205 | $105K |
| D1351 | Sealant - per tooth | 18% | 3,471 | 610 | $96K |
| D0272 | Bitewings - two radiographic images | 5.5% | 2,111 | 2,071 | $28K |
| D1999 | 2.2% | 1,183 | 1,165 | $12K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.9% | 116 | 64 | $10K |
| D1110 | Prophylaxis - adult | 1.1% | 156 | 152 | $6K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.1% | 180 | 174 | $6K |
| D0330 | Panoramic radiographic image | <1% | 117 | 117 | $4K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 40 | 40 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 20 | 14 | $1K |
4 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 officialDASCH, CHARLOTTE (DIRECTOR OF PROVIDER RELATIOND)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.