Dental
Phoenix Pediatric Dental, LLC
Phoenix Pediatric Dental, LLC was paid $7.66M by Medicaid between Jan 2018 and Dec 2024, across 37 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 14% of everything it billed.
33Billing provider infoPHOENIX PEDIATRIC DENTAL, LLC
PHOENIX, AZ 85015
PHOENIX, AZ 85015
33aNPI1891875498assigned 10/17/2006
33bProvider typePediatric Dentist
28Total paid$7.66M
24GClaims701,801
24DCodes billed37
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#2 of 223
Median peer was paid$24K
This provider vs. median325×
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 | 62,170 | $473K | |
| 2019 | 78,688 | $618K | |
| 2020 | 86,674 | $646K | |
| 2021 | 118,910 | $1.13M | |
| 2022 | 118,044 | $1.62M | |
| 2023 | 115,897 | $1.61M | |
| 2024incomplete | 121,418 | $1.57M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14% | 34,849 | 14,208 | $1.04M |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 68,664 | 67,490 | $872K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.7% | 79,440 | 78,139 | $670K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8.2% | 15,048 | 4,555 | $630K |
| D1208 | Topical application of fluoride, excluding varnish | 7.0% | 88,338 | 86,789 | $534K |
| D7140 | Extraction, erupted tooth or exposed root | 5.1% | 14,682 | 6,028 | $394K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.1% | 92,854 | 79,692 | $389K |
| D0220 | Intraoral - periapical first radiographic image | 5.0% | 87,578 | 85,316 | $386K |
| D0272 | Bitewings - two radiographic images | 4.8% | 53,366 | 52,269 | $366K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 4.5% | 9,351 | 5,065 | $345K |
| D1110 | Prophylaxis - adult | 4.3% | 20,828 | 20,411 | $327K |
| D1999 | 2.7% | 25,426 | 23,276 | $209K |
25 more codes
| D0274 | Bitewings - four radiographic images | 2.7% | 20,627 | $207K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.4% | 5,913 | $183K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.1% | 6,177 | $157K |
| D0330 | Panoramic radiographic image | 2.0% | 9,650 | $157K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.8% | 9,715 | $140K |
| D2390 | 1.7% | 2,126 | $129K | |
| D9248 | 1.7% | 4,713 | $128K | |
| D1351 | Sealant - per tooth | 1.6% | 14,444 | $123K |
| D0140 | Limited oral evaluation - problem focused | 1.4% | 9,130 | $106K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.2% | 12,934 | $88K |
| D1206 | Topical application of fluoride varnish | <1% | 3,705 | $27K |
| D2394 | <1% | 511 | $19K | |
| D3230 | <1% | 424 | $13K | |
| D2330 | <1% | 263 | $6K | |
| D2332 | <1% | 130 | $6K | |
| D0240 | <1% | 1,745 | $6K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 45 | $2K |
| D2929 | <1% | 38 | $1K | |
| D3120 | <1% | 57 | $748.16 | |
| D0270 | <1% | 71 | $322.17 | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 79 | $126.50 |
| D0170 | <1% | 14 | $25.00 | |
| D0601 | 0% | 4,418 | $0.00 | |
| D9994 | 0% | 2,402 | $0.00 | |
| D1330 | 0% | 2,046 | $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 officialPACHECO, LUZ (BUSINESS MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Phoenix Pediatric Dental | Phoenix, AZ | $62K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.