Supplier
Sincere Smiles PC
Sincere Smiles PC was paid $40K by Medicaid between May 2018 and Oct 2024, across 4 billing codes. Its largest line is D1120, dental cleaning, child — 33% of everything it billed.
33Billing provider infoSINCERE SMILES PC
WILLISTON, ND 58801
WILLISTON, ND 58801
33aNPI1881933034assigned 02/07/2013
33bProvider typeCustomized Equipment (DME)
28Total paid$40K
24GClaims1,331
24DCodes billed4
24AFirst – last monthMay 2018 – Oct 2024
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 | 128 | $3K | |
| 2019 | 149 | $4K | |
| 2020 | 12 | $377.02 | |
| 2021 | 153 | $5K | |
| 2022 | 252 | $7K | |
| 2023 | 315 | $10K | |
| 2024incomplete | 322 | $10K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 33% | 359 | 346 | $13K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 29% | 419 | 405 | $12K |
| D1206 | Topical application of fluoride varnish | 24% | 375 | 361 | $9K |
| D1351 | Sealant - per tooth | 14% | 178 | 63 | $6K |
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 officialDORNFELD, KAMILA (OWNER)