Dental
Pediatric Dental Excellence, LLC
Pediatric Dental Excellence, LLC was paid $76K by Medicaid between Jul 2024 and Dec 2024, across 18 billing codes. Its largest line is D1351, Sealant - per tooth — 28% of everything it billed.
33Billing provider infoPEDIATRIC DENTAL EXCELLENCE, LLC
PHILA, PA 19129
PHILA, PA 19129
33aNPI1902544711assigned 05/23/2022
33bProvider typePediatric Dentist
28Total paid$76K
24GClaims2,846
24DCodes billed18
24AFirst – last monthJul 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Pennsylvania
Rank by total paid#132 of 237
Median peer was paid$109K
This provider vs. median0.7×
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 | 2,846 | $76K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 28% | 141 | 122 | $21K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 61 | 52 | $8K |
| D1206 | Topical application of fluoride varnish | 10.0% | 415 | 405 | $8K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.5% | 260 | 259 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.2% | 228 | 227 | $5K |
| D7140 | Extraction, erupted tooth or exposed root | 4.9% | 34 | 29 | $4K |
| D0603 | 4.1% | 346 | 344 | $3K | |
| D0240 | 3.6% | 108 | 106 | $3K | |
| D1110 | Prophylaxis - adult | 3.5% | 71 | 71 | $3K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.3% | 80 | 78 | $3K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.1% | 120 | 120 | $2K |
| D0274 | Bitewings - four radiographic images | 3.1% | 78 | 78 | $2K |
6 more codes
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 officialDAVIS, RYAN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Tieton Village Drug INC. | Yakima, WA | $443K |
| Davis Chiropractic Health & Wellness, P.A | Grand Rapids, MN | $351K |
| Georgetown Family Medicine | Georgetown, DE | $8K |
| United Health Centers | Winston Salem, NC | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.