Dental
Modern Dental Specialist, LLC
Modern Dental Specialist, LLC was paid $94K by Medicaid between Jul 2023 and Dec 2024, across 11 billing codes. Its largest line is D0330, Panoramic radiographic image — 24% of everything it billed.
33Billing provider infoMODERN DENTAL SPECIALIST, LLC
LAS VEGAS, NV 89107
LAS VEGAS, NV 89107
33aNPI1912607433assigned 03/03/2023
33bProvider typePeriodontist
28Total paid$94K
24GClaims4,738
24DCodes billed11
24AFirst – last monthJul 2023 – Dec 2024
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 | |
|---|---|---|---|
| 2023 | 1,815 | $36K | |
| 2024incomplete | 2,923 | $58K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 24% | 630 | 616 | $23K |
| D0150 | Comprehensive oral evaluation - new or established patient | 19% | 682 | 655 | $18K |
| D0274 | Bitewings - four radiographic images | 18% | 767 | 734 | $17K |
| D0220 | Intraoral - periapical first radiographic image | 12% | 915 | 875 | $11K |
| D1351 | Sealant - per tooth | 8.0% | 364 | 43 | $8K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.1% | 1,005 | 860 | $6K |
| D1206 | Topical application of fluoride varnish | 3.8% | 115 | 112 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.8% | 91 | 90 | $4K |
| D0140 | Limited oral evaluation - problem focused | 2.8% | 81 | 80 | $3K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 2.2% | 73 | 31 | $2K |
| D0272 | Bitewings - two radiographic images | <1% | 15 | 15 | $237.60 |
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 officialSAVCIC, ANASTASIA (HUMAN RESOURSE)
| Provider | Location | Paid |
|---|---|---|
| Modern Dental Specialist, LLC | Las Vegas, NV | $16K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.