Dental
Pediatric Dental Care Center
Pediatric Dental Care Center was paid $409K by Medicaid between Jan 2018 and Sep 2020, across 18 billing codes. Its largest line is D0120, dental checkup, returning patient — 23% of everything it billed.
33Billing provider infoPEDIATRIC DENTAL CARE CENTER
TACOMA, WA 98405
TACOMA, WA 98405
33aNPI1790947778assigned 06/30/2008
33bProvider typePediatric Dentist
28Total paid$409K
24GClaims18,652
24DCodes billed18
24AFirst – last monthJan 2018 – Sep 2020
Compared with peers
Next to other Pediatric Dentist providers in Washington
Rank by total paid#74 of 156
Median peer was paid$337K
This provider vs. median1.2×
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 | 7,018 | $155K | |
| 2019 | 8,325 | $185K | |
| 2020 | 3,309 | $68K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 23% | 4,043 | 4,034 | $95K |
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 3,637 | 3,630 | $83K |
| D1206 | Topical application of fluoride varnish | 17% | 4,192 | 4,183 | $69K |
| D1110 | Prophylaxis - adult | 7.0% | 795 | 792 | $28K |
| D9999 | Unspecified adjunctive procedure, by report | 6.2% | 917 | 916 | $25K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.1% | 1,039 | 967 | $21K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.0% | 407 | 248 | $21K |
| D0272 | Bitewings - two radiographic images | 3.4% | 1,379 | 1,376 | $14K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.3% | 361 | 360 | $14K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.8% | 115 | 87 | $7K |
| D0274 | Bitewings - four radiographic images | 1.8% | 495 | 494 | $7K |
| D1351 | Sealant - per tooth | 1.8% | 356 | 121 | $7K |
6 more codes
| D1999 | 1.7% | 465 | $7K | |
| D1208 | Topical application of fluoride, excluding varnish | 1.0% | 314 | $4K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 18 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 78 | $2K |
| D0330 | Panoramic radiographic image | <1% | 25 | $978.65 |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 16 | $916.80 |
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 officialGIBBONS, JOHN (DOCTOR)