Dental
Pediatric Dentistry of Michigan PLLC
Pediatric Dentistry of Michigan PLLC was paid $2.03M by Medicaid between Nov 2020 and Dec 2024, across 20 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 26% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF MICHIGAN PLLC
GRAND RAPIDS, MI 49525
GRAND RAPIDS, MI 49525
33aNPI1831702695assigned 08/30/2020
33bProvider typePediatric Dentist
28Total paid$2.03M
24GClaims37,343
24DCodes billed20
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#35 of 153
Median peer was paid$464K
This provider vs. median4.4×
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 | 292 | $11K | |
| 2021 | 4,664 | $181K | |
| 2022 | 7,958 | $425K | |
| 2023 | 11,284 | $665K | |
| 2024incomplete | 13,145 | $747K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 26% | 2,604 | 1,181 | $522K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 5,021 | 5,017 | $215K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 10% | 1,628 | 1,130 | $210K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 8.0% | 1,244 | 663 | $162K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.9% | 1,479 | 1,087 | $140K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.2% | 3,666 | 3,664 | $126K |
| D7140 | Extraction, erupted tooth or exposed root | 5.3% | 1,094 | 619 | $108K |
| D1208 | Topical application of fluoride, excluding varnish | 4.3% | 3,553 | 3,551 | $87K |
| D0220 | Intraoral - periapical first radiographic image | 3.5% | 3,885 | 3,827 | $71K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.4% | 1,112 | 1,112 | $69K |
| D0272 | Bitewings - two radiographic images | 2.8% | 2,765 | 2,756 | $57K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.7% | 4,278 | 3,336 | $55K |
8 more codes
| D0140 | Limited oral evaluation - problem focused | 2.3% | 762 | $47K |
| D1206 | Topical application of fluoride varnish | 2.2% | 1,470 | $45K |
| D1351 | Sealant - per tooth | 1.9% | 1,221 | $39K |
| D1510 | 1.2% | 119 | $25K | |
| D1354 | <1% | 741 | $20K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 446 | $18K |
| D1110 | Prophylaxis - adult | <1% | 205 | $10K |
| D0274 | Bitewings - four radiographic images | <1% | 50 | $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 officialKIM, WANKI (OWNER)