Dental
Sun Valley Pediatric Dentistry, PLLC
Sun Valley Pediatric Dentistry, PLLC was paid $267K by Medicaid between Jan 2018 and Mar 2020, across 22 billing codes. Its largest line is D1120, dental cleaning, child — 21% of everything it billed.
33Billing provider infoSUN VALLEY PEDIATRIC DENTISTRY, PLLC
AVONDALE, AZ 85392
AVONDALE, AZ 85392
33aNPI1881074318assigned 05/29/2015
33bProvider typePediatric Dentist
28Total paid$267K
24GClaims47,259
24DCodes billed22
24AFirst – last monthJan 2018 – Mar 2020
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#50 of 223
Median peer was paid$24K
This provider vs. median11×
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 | 21,117 | $137K | |
| 2019 | 20,993 | $110K | |
| 2020 | 5,149 | $21K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 21% | 6,248 | 6,176 | $55K |
| D1206 | Topical application of fluoride varnish | 11% | 7,045 | 6,954 | $31K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 5,384 | 5,329 | $29K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 10% | 1,186 | 636 | $27K |
| D0220 | Intraoral - periapical first radiographic image | 6.7% | 6,882 | 6,757 | $18K |
| D0272 | Bitewings - two radiographic images | 6.7% | 4,159 | 4,104 | $18K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.8% | 7,108 | 6,320 | $15K |
| D1351 | Sealant - per tooth | 5.3% | 2,142 | 664 | $14K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.2% | 923 | 902 | $11K |
| D0274 | Bitewings - four radiographic images | 2.8% | 1,312 | 1,290 | $8K |
| D7140 | Extraction, erupted tooth or exposed root | 2.6% | 541 | 330 | $7K |
| D1110 | Prophylaxis - adult | 2.5% | 610 | 598 | $7K |
10 more codes
| D0330 | Panoramic radiographic image | 2.4% | 993 | $6K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.3% | 1,449 | $6K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.7% | 229 | $5K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.6% | 224 | $4K |
| D0145 | Oral evaluation for a patient under three years of age | 1.5% | 502 | $4K |
| D9248 | <1% | 77 | $1K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 137 | $876.36 |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 16 | $284.60 |
| D0602 | 0% | 80 | $0.00 | |
| D0603 | 0% | 12 | $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 officialJOHNSON, JAIME (CONTROLLER)
| Provider | Location | Paid |
|---|---|---|
| Higley Village Kidtastic, LLC | Gilbert, AZ | $67K |
| Fiesta Kidtastic, LLC | Mesa, AZ | $21K |
| Santan Kidtastic LLC | San Tan Valley, AZ | $6K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.