Dental
White Smiles Pediatric Dentistry
White Smiles Pediatric Dentistry was paid $1.21M by Medicaid between Jul 2019 and Dec 2024, across 17 billing codes. Its largest line is D0120, dental checkup, returning patient — 46% of everything it billed.
33Billing provider infoWHITE SMILES PEDIATRIC DENTISTRY
VERNAL, UT 84078
VERNAL, UT 84078
33aNPI1881257657assigned 04/17/2019
33bProvider typePediatric Dentist
28Total paid$1.21M
24GClaims38,709
24DCodes billed17
24AFirst – last monthJul 2019 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Utah
Rank by total paid#24 of 152
Median peer was paid$311K
This provider vs. median3.9×
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 | |
|---|---|---|---|
| 2019 | 2,582 | $82K | |
| 2020 | 5,535 | $167K | |
| 2021 | 6,679 | $217K | |
| 2022 | 11,069 | $364K | |
| 2023 | 7,067 | $213K | |
| 2024incomplete | 5,777 | $170K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 46% | 6,214 | 6,177 | $554K |
| D1351 | Sealant - per tooth | 11% | 3,661 | 843 | $137K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.1% | 6,315 | 6,266 | $99K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.4% | 726 | 124 | $90K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.3% | 746 | 733 | $89K |
| D0272 | Bitewings - two radiographic images | 4.6% | 4,244 | 4,199 | $56K |
| D1206 | Topical application of fluoride varnish | 3.7% | 6,246 | 6,193 | $44K |
| D0220 | Intraoral - periapical first radiographic image | 2.7% | 4,782 | 4,714 | $33K |
| D7140 | Extraction, erupted tooth or exposed root | 2.5% | 304 | 116 | $30K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 2.3% | 325 | 146 | $28K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.5% | 4,453 | 4,332 | $18K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.5% | 219 | 112 | $18K |
5 more codes
| D2140 | <1% | 146 | $9K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 69 | $4K |
| D0330 | Panoramic radiographic image | <1% | 195 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 31 | $2K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 33 | $1K |
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 officialWHITE, TRAVIS (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Deer Creek Childrens Dentistry | Heber City, UT | $34K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.