Dental
Supersmiles KDS Dental PC
Supersmiles KDS Dental PC was paid $5.88M by Medicaid between Jan 2019 and Dec 2024, across 28 billing codes. Its largest line is D1120, dental cleaning, child — 20% of everything it billed.
33Billing provider infoSUPERSMILES KDS DENTAL PC
RIVERHEAD, NY 11901
RIVERHEAD, NY 11901
33aNPI1922586841assigned 08/02/2018
33bProvider typePediatric Dentist
28Total paid$5.88M
24GClaims155,379
24DCodes billed28
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in New York
Rank by total paid#17 of 514
Median peer was paid$196K
This provider vs. median30×
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 | |
|---|---|---|---|
| 2019 | 10,428 | $466K | |
| 2020 | 12,845 | $606K | |
| 2021 | 20,732 | $842K | |
| 2022 | 29,640 | $1.09M | |
| 2023 | 37,312 | $1.36M | |
| 2024incomplete | 44,422 | $1.51M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 27,346 | 27,301 | $1.19M |
| D1208 | Topical application of fluoride, excluding varnish | 14% | 32,672 | 32,623 | $851K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14% | 6,010 | 4,865 | $841K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 28,663 | 28,619 | $802K |
| D1351 | Sealant - per tooth | 5.5% | 5,932 | 2,630 | $324K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.8% | 2,775 | 2,369 | $282K |
| D1110 | Prophylaxis - adult | 4.1% | 5,354 | 5,347 | $242K |
| D7140 | Extraction, erupted tooth or exposed root | 3.7% | 2,221 | 1,741 | $216K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.8% | 879 | 825 | $164K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.5% | 3,925 | 3,921 | $149K |
| D0272 | Bitewings - two radiographic images | 2.5% | 9,088 | 9,080 | $147K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.3% | 985 | 913 | $138K |
16 more codes
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 10,190 | $125K |
| D0210 | Intraoral - complete series of radiographic images | 1.6% | 8,092 | $91K |
| D0330 | Panoramic radiographic image | 1.5% | 2,006 | $86K |
| D9990 | 1.3% | 3,614 | $79K | |
| D0274 | Bitewings - four radiographic images | <1% | 2,042 | $51K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 255 | $32K |
| D0140 | Limited oral evaluation - problem focused | <1% | 678 | $18K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 100 | $13K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,083 | $11K |
| D1354 | <1% | 649 | $10K | |
| D1206 | Topical application of fluoride varnish | <1% | 373 | $9K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 167 | $5K |
| D2140 | <1% | 18 | $1K | |
| D2330 | <1% | 15 | $1K | |
| D9430 | <1% | 32 | $541.80 | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 215 | $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 officialKOURTSOUNIS, PARASKEVAS (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Dental Smiles for Kids, LLC | Astoria, NY | $604K |
| Dental Smiles for Kids, LLC | North Babylon, NY | $181K |
| Dental Smiles for Kids, LLC | Ronkonkoma, NY | $150K |
| Dental Smiles for Kids, LLC | Centereach, NY | $79K |
| Dental Smiles for Kids | Levittown, NY | $65K |
| Dental Smiles for Kids, LLC | Levittown, NY | $348.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.