Dental
Marketside Street Dental LLC
Marketside Street Dental LLC was paid $28K by Medicaid between Oct 2023 and Dec 2024, across 16 billing codes. Its largest line is D1120, dental cleaning, child — 25% of everything it billed.
33Billing provider infoMARKETSIDE STREET DENTAL LLC
BUCKEYE, AZ 85396
BUCKEYE, AZ 85396
33aNPI1952020612assigned 08/25/2022
33bProvider typePediatric Dentist
28Total paid$28K
24GClaims4,311
24DCodes billed16
24AFirst – last monthOct 2023 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#105 of 223
Median peer was paid$24K
This provider vs. median1.2×
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 | |
|---|---|---|---|
| 2023 | 233 | $872.78 | |
| 2024incomplete | 4,078 | $27K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 635 | 612 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14% | 352 | 329 | $4K |
| D1206 | Topical application of fluoride varnish | 12% | 626 | 597 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 11% | 809 | 754 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 9.5% | 802 | 654 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.7% | 97 | 46 | $2K |
| D0272 | Bitewings - two radiographic images | 6.4% | 327 | 308 | $2K |
| D1351 | Sealant - per tooth | 3.7% | 137 | 37 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.7% | 139 | 120 | $756.03 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.5% | 72 | 72 | $698.61 |
| D0274 | Bitewings - four radiographic images | 1.5% | 39 | 35 | $416.55 |
| D1208 | Topical application of fluoride, excluding varnish | 1.2% | 70 | 69 | $339.00 |
4 more codes
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 officialGARCIA, JENNY (CREDENTIALING LEAD)
| Provider | Location | Paid |
|---|---|---|
| Spearmint Kids and Orthodontics PLLC | Wichita Falls, TX | $562K |
| College Station Dentistry and Orthodontics PLLC | College Station, TX | $67K |
| South Tyler Family Dentistry PLLC | Tyler, TX | $34K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.