Clinic
San Gabriel Dental Practice
San Gabriel Dental Practice was paid $196K by Medicaid between Jan 2018 and Nov 2024, across 15 billing codes. Its largest line is D0120, dental checkup, returning patient — 19% of everything it billed.
33Billing provider infoSAN GABRIEL DENTAL PRACTICE
MONTEBELLO, CA 90640
MONTEBELLO, CA 90640
33aNPI1912300427assigned 09/29/2014
33bProvider typeDental Clinic/Center
28Total paid$196K
24GClaims11,351
24DCodes billed15
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#575 of 1,135
Median peer was paid$200K
This provider vs. median1.0×
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 | 2,120 | $21K | |
| 2019 | 1,993 | $30K | |
| 2020 | 1,247 | $17K | |
| 2021 | 1,787 | $30K | |
| 2022 | 822 | $13K | |
| 2023 | 1,317 | $23K | |
| 2024incomplete | 2,065 | $63K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 19% | 756 | 748 | $36K |
| D0150 | Comprehensive oral evaluation - new or established patient | 13% | 394 | 393 | $25K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 353 | 199 | $23K |
| D0230 | Intraoral - periapical each additional radiographic image | 11% | 5,478 | 1,060 | $22K |
| D0350 | 8.0% | 1,607 | 641 | $16K | |
| D1206 | Topical application of fluoride varnish | 7.1% | 1,081 | 1,077 | $14K |
| D1110 | Prophylaxis - adult | 6.6% | 161 | 161 | $13K |
| D4341 | 5.8% | 162 | 49 | $11K | |
| D1120 | Dental cleaning, childProphylaxis - child | 5.7% | 332 | 330 | $11K |
| D0210 | Intraoral - complete series of radiographic images | 5.6% | 235 | 230 | $11K |
| D0272 | Bitewings - two radiographic images | 3.7% | 632 | 626 | $7K |
| D9430 | 1.2% | 76 | 72 | $2K |
3 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 officialREYES, MARTIN (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Reyes&reyes D.D.S Dental Corp | Azusa, CA | $434K |
| MG Reyes Dental Corporation | Baldwin Park, CA | $31K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.