Dental
West Michigan Pediatric Dentistry
West Michigan Pediatric Dentistry was paid $13.81M by Medicaid between Jan 2018 and Dec 2024, across 32 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 14% of everything it billed.
33Billing provider infoWEST MICHIGAN PEDIATRIC DENTISTRY
HOLLAND, MI 49423
HOLLAND, MI 49423
33aNPI1942327259assigned 03/23/2007
33bProvider typePediatric Dentist
28Total paid$13.81M
24GClaims281,134
24DCodes billed32
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#3 of 153
Median peer was paid$464K
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 | |
|---|---|---|---|
| 2018 | 19,902 | $1.07M | |
| 2019 | 26,648 | $1.34M | |
| 2020 | 31,908 | $1.41M | |
| 2021 | 50,142 | $2.26M | |
| 2022 | 51,023 | $2.54M | |
| 2023 | 50,024 | $2.51M | |
| 2024incomplete | 51,487 | $2.68M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 14% | 10,125 | 4,063 | $1.97M |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 40,480 | 40,464 | $1.71M |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 13,412 | 7,866 | $1.67M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 44,051 | 44,041 | $1.51M |
| D1206 | Topical application of fluoride varnish | 9.4% | 46,525 | 46,485 | $1.30M |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.6% | 8,255 | 5,748 | $776K |
| D0272 | Bitewings - two radiographic images | 4.5% | 33,409 | 33,384 | $624K |
| D7140 | Extraction, erupted tooth or exposed root | 4.5% | 6,928 | 4,001 | $623K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 3.4% | 3,693 | 2,219 | $474K |
| D1351 | Sealant - per tooth | 3.1% | 14,726 | 4,310 | $431K |
| D1110 | Prophylaxis - adult | 2.9% | 7,437 | 7,436 | $403K |
| D2390 | 2.9% | 2,111 | 904 | $395K |
20 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 2.4% | 5,923 | $338K |
| D2331 | 2.4% | 3,237 | $332K | |
| D2330 | 2.2% | 3,724 | $303K | |
| D1510 | 1.3% | 863 | $173K | |
| D0240 | <1% | 7,015 | $134K | |
| D0330 | Panoramic radiographic image | <1% | 1,498 | $106K |
| D0140 | Limited oral evaluation - problem focused | <1% | 1,733 | $104K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 6,071 | $79K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 3,613 | $67K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 442 | $66K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 1,431 | $60K |
| D9248 | <1% | 1,276 | $53K | |
| D2140 | <1% | 541 | $41K | |
| D2332 | <1% | 210 | $27K | |
| D1354 | <1% | 635 | $16K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 168 | $16K |
| D9420 | <1% | 112 | $15K | |
| D7111 | <1% | 70 | $5K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 567 | $3K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 10,853 | $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 officialWISSINK, KATHY (OFFICE MANAGER)