Clinic
Grenada Dental Clinic PLLC
Grenada Dental Clinic PLLC was paid $109K by Medicaid between Oct 2018 and Oct 2024, across 14 billing codes. Its largest line is D1120, dental cleaning, child — 28% of everything it billed.
33Billing provider infoGRENADA DENTAL CLINIC PLLC
GRENADA, MS 38901
GRENADA, MS 38901
33aNPI1851886857assigned 06/22/2018
33bProvider typeDental Clinic/Center
28Total paid$109K
24GClaims4,324
24DCodes billed14
24AFirst – last monthOct 2018 – Oct 2024
Compared with peers
Next to other Dental Clinic/Center providers in Mississippi
Rank by total paid#25 of 53
Median peer was paid$44K
This provider vs. median2.5×
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 | 42 | $1K | |
| 2019 | 684 | $21K | |
| 2020 | 448 | $9K | |
| 2021 | 856 | $23K | |
| 2022 | 1,651 | $36K | |
| 2023 | 355 | $10K | |
| 2024incomplete | 288 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 28% | 1,183 | 1,019 | $30K |
| D1206 | Topical application of fluoride varnish | 14% | 679 | 585 | $15K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 528 | 458 | $12K |
| D0274 | Bitewings - four radiographic images | 9.6% | 482 | 411 | $11K |
| D0330 | Panoramic radiographic image | 9.6% | 299 | 243 | $10K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.9% | 306 | 248 | $9K |
| D0140 | Limited oral evaluation - problem focused | 6.9% | 238 | 205 | $8K |
| D7140 | Extraction, erupted tooth or exposed root | 4.5% | 62 | 37 | $5K |
| D1351 | Sealant - per tooth | 3.3% | 305 | 28 | $4K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.9% | 28 | 14 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.8% | 22 | 15 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 1.0% | 134 | 101 | $1K |
2 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 officialVAN GORDON, OLIVIA (DENTIST)