Clinic
Kahului Dentists LLC
Kahului Dentists LLC was paid $153K by Medicaid between Dec 2021 and Dec 2024, across 11 billing codes. Its largest line is D1110, Prophylaxis - adult — 26% of everything it billed.
33Billing provider infoKAHULUI DENTISTS LLC
KAHULUI, HI 96732
KAHULUI, HI 96732
33aNPI1891268108assigned 01/09/2019
33bProvider typeDental Clinic/Center
28Total paid$153K
24GClaims5,119
24DCodes billed11
24AFirst – last monthDec 2021 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Hawaii
Rank by total paid#8 of 23
Median peer was paid$52K
This provider vs. median2.9×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official WONG, LISA controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2021 | 60 | $1K | |
| 2022 | 458 | $9K | |
| 2023 | 2,187 | $63K | |
| 2024incomplete | 2,414 | $79K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 26% | 825 | 825 | $40K |
| D1206 | Topical application of fluoride varnish | 13% | 790 | 790 | $20K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 529 | 529 | $19K |
| D0220 | Intraoral - periapical first radiographic image | 12% | 1,134 | 1,111 | $18K |
| D0274 | Bitewings - four radiographic images | 8.3% | 304 | 304 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.8% | 308 | 308 | $12K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.1% | 85 | 43 | $11K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.7% | 877 | 712 | $10K |
| D0140 | Limited oral evaluation - problem focused | 4.5% | 192 | 187 | $7K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.3% | 61 | 61 | $2K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 14 | 14 | $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 officialWONG, LISA (DENTIST)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.