Dental
Southern Pines Dental, LLC
Southern Pines Dental, LLC was paid $666K by Medicaid between Jan 2018 and Dec 2021, across 17 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 29% of everything it billed.
33Billing provider infoSOUTHERN PINES DENTAL, LLC
ARCADIA, LA 71001
ARCADIA, LA 71001
33aNPI1922457175assigned 06/08/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$666K
24GClaims17,217
24DCodes billed17
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other General Practice Dentistry providers in Louisiana
Rank by total paid#74 of 412
Median peer was paid$83K
This provider vs. median8.0×
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 | 4,839 | $198K | |
| 2019 | 4,201 | $169K | |
| 2020 | 3,323 | $129K | |
| 2021 | 4,854 | $170K |
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 | 29% | 2,420 | 1,383 | $192K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 16% | 3,302 | 2,354 | $108K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.6% | 2,393 | 2,286 | $58K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.5% | 1,840 | 1,806 | $57K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 8.1% | 964 | 620 | $54K |
| D1110 | Prophylaxis - adult | 7.8% | 1,214 | 1,190 | $52K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 7.7% | 534 | 342 | $51K |
| D1208 | Topical application of fluoride, excluding varnish | 4.6% | 1,711 | 1,679 | $30K |
| D0272 | Bitewings - two radiographic images | 4.3% | 1,497 | 1,470 | $29K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.8% | 313 | 283 | $12K |
| D1206 | Topical application of fluoride varnish | 1.6% | 492 | 478 | $11K |
| D0330 | Panoramic radiographic image | <1% | 122 | 114 | $5K |
5 more codes
| D0220 | Intraoral - periapical first radiographic image | <1% | 261 | $3K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 16 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 107 | $2K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 19 | $1K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 12 | $722.04 |
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 officialROBERTS, JESSE (OWNER/DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Peach Tree for Kids - Ruston, LLC | Ruston, LA | $8.98M |
| J & J Dental | Monroe, LA | $2.16M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.