Dental
Super Smiles Maricopa PLLC
Super Smiles Maricopa PLLC was paid $9K by Medicaid between Jun 2024 and Dec 2024, across 6 billing codes. Its largest line is D1120, dental cleaning, child — 30% of everything it billed.
33Billing provider infoSUPER SMILES MARICOPA PLLC
MARICOPA, AZ 85139
MARICOPA, AZ 85139
33aNPI1891556502assigned 01/19/2024
33bProvider typePediatric Dentist
28Total paid$9K
24GClaims368
24DCodes billed6
24AFirst – last monthJun 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#140 of 223
Median peer was paid$24K
This provider vs. median0.4×
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 | |
|---|---|---|---|
| 2024incomplete | 368 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 30% | 72 | 71 | $3K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 24% | 79 | 78 | $2K |
| D1206 | Topical application of fluoride varnish | 23% | 108 | 105 | $2K |
| D0274 | Bitewings - four radiographic images | 19% | 51 | 51 | $2K |
| D0240 | 4.2% | 44 | 17 | $361.99 | |
| D0603 | 0% | 14 | 14 | $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 officialKUPPANDA, NIKITA (DDS/ OWNER)