Dental
Pembroke Pines Pediatric Dentistry
Pembroke Pines Pediatric Dentistry was paid $19K by Medicaid between Sep 2018 and Mar 2020, across 9 billing codes. Its largest line is D0272, Bitewings - two radiographic images — 40% of everything it billed.
33Billing provider infoPEMBROKE PINES PEDIATRIC DENTISTRY
PEMBROKE PINES, FL 33026
PEMBROKE PINES, FL 33026
33aNPI1942424700assigned 04/12/2007
33bProvider typePediatric Dentist
28Total paid$19K
24GClaims1,095
24DCodes billed9
24AFirst – last monthSep 2018 – Mar 2020
Compared with peers
Next to other Pediatric Dentist providers in Florida
Rank by total paid#181 of 246
Median peer was paid$107K
This provider vs. median0.2×
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 | 357 | $6K | |
| 2020 | 738 | $13K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0272 | Bitewings - two radiographic images | 40% | 152 | 151 | $7K |
| D1330 | 16% | 203 | 203 | $3K | |
| D0330 | Panoramic radiographic image | 15% | 28 | 28 | $3K |
| D1351 | Sealant - per tooth | 8.8% | 164 | 37 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.8% | 165 | 165 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.9% | 137 | 137 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 3.1% | 183 | 183 | $587.26 |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.9% | 14 | 14 | $356.00 |
| D1110 | Prophylaxis - adult | <1% | 49 | 49 | $159.05 |
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 officialGARRASTAZU, JUAN (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Doral Pediatric Dentistry, LLC | Doral, FL | $902K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.