Dental
Smile Station Pediatric Dentistry, PLLC
Smile Station Pediatric Dentistry, PLLC was paid $1.45M by Medicaid between Aug 2020 and Dec 2024, across 24 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 42% of everything it billed.
33Billing provider infoSMILE STATION PEDIATRIC DENTISTRY, PLLC
EDINBURG, TX 78539
EDINBURG, TX 78539
33aNPI1801198437assigned 12/02/2010
33bProvider typePediatric Dentist
28Total paid$1.45M
24GClaims37,545
24DCodes billed24
24AFirst – last monthAug 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#149 of 693
Median peer was paid$252K
This provider vs. median5.8×
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 | |
|---|---|---|---|
| 2020 | 1,203 | $43K | |
| 2021 | 9,542 | $358K | |
| 2022 | 10,822 | $429K | |
| 2023 | 10,655 | $422K | |
| 2024incomplete | 5,323 | $203K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 42% | 4,372 | 884 | $607K |
| D0145 | Oral evaluation for a patient under three years of age | 11% | 1,128 | 1,117 | $158K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.8% | 3,577 | 3,536 | $129K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.5% | 4,397 | 4,337 | $124K |
| D0272 | Bitewings - two radiographic images | 4.1% | 2,848 | 2,751 | $60K |
| D1206 | Topical application of fluoride varnish | 4.0% | 4,069 | 4,027 | $59K |
| D1351 | Sealant - per tooth | 4.0% | 2,251 | 753 | $59K |
| D9248 | 3.5% | 443 | 436 | $51K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 1,282 | 1,260 | $44K |
| D0274 | Bitewings - four radiographic images | 2.6% | 1,162 | 1,155 | $38K |
| D1110 | Prophylaxis - adult | 2.5% | 681 | 674 | $36K |
| D0220 | Intraoral - periapical first radiographic image | 1.5% | 1,901 | 1,788 | $21K |
12 more codes
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.4% | 270 | $21K |
| D0330 | Panoramic radiographic image | <1% | 313 | $10K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,147 | $9K |
| D9420 | <1% | 266 | $9K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 72 | $7K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 103 | $6K |
| D9430 | <1% | 261 | $2K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 32 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 96 | $2K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 39 | $948.85 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 57 | $808.50 |
| D0603 | 0% | 6,778 | $0.00 |
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 officialGARZA-PEISEN, KRYSTLE (PEDIATRIC DENTIST)