NORTHERN NEVADA DENTAL SPECIALTIES GROUP, LLC SOS Verified
5030 LAS BRISAS BLVD STE B-3, RENO, NV 89523
NPI Number
1043725039
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: NORTHERN NEVADA DENTAL SPECIALTIES GROUP LLC
Entity Number: E0174792012-0
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2012-03-28
Name Match: 95%
Registered Agent
Name: SHAY L WELLS
Type: Commercial Registered Agent
Address: 6100 NEIL RD STE 500, Reno, NV, 89511
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | BLUETREE DENTAL LLC | C/O WOODBURN AND WEDGE PO BOX 2311, RENO, NV, 89505 | Active |
Total Medicaid Payments
$886,181
-28% vs specialty average
Patients Seen
25,515
Total Claims
32,549
$ Per Patient
$35
Specialty avg: $40
Specialty Rank
#24 of 98
Dentist, Pediatric Dentistry providers in Nevada
Peer Average
$1,233,441
Average total for Dentist, Pediatric Dentistry
Claims per Patient
1.3
Average visits / services per person
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2020 | $24,808 | |
| 2021 | $174,460 | |
| 2022 | $197,863 | |
| 2023 | $233,897 | |
| 2024 | $255,152 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 4,566 | $212,403 | 24.0% | $47 |
| D1120 | Dental cleaning for children (prophylaxis) | 4,259 | $208,916 | 23.6% | $49 |
| D0120 | Regular dental checkup and exam | 3,986 | $113,882 | 12.9% | $29 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 2,512 | $51,059 | 5.8% | $20 |
| D2392 | Tooth-colored (resin) filling — two surfaces, back tooth | 937 | $44,297 | 5.0% | $47 |
| D2391 | Tooth-colored (resin) filling — one surface, back tooth | 1,187 | $43,752 | 4.9% | $37 |
| D0272 | Dental X-ray — bitewings (two films) | 2,002 | $35,738 | 4.0% | $18 |
| D0220 | Single dental X-ray (of one tooth) | 2,687 | $34,274 | 3.9% | $13 |
| D0230 | Additional dental X-ray | 5,642 | $29,837 | 3.4% | $5 |
| D1110 | Dental cleaning for adults (prophylaxis) | 627 | $28,192 | 3.2% | $45 |
| D9230 | Analgesia (pain management during dental work, like nitrous oxide/laughing gas) | 1,592 | $26,922 | 3.0% | $17 |
| D0274 | Dental X-ray — bitewings (four films) | 772 | $16,278 | 1.8% | $21 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 519 | $15,362 | 1.7% | $30 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 250 | $8,522 | 1.0% | $34 |
| D0999 | Dental exam, X-ray, or screening | 156 | $4,680 | 0.5% | $30 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 169 | $4,521 | 0.5% | $27 |
| D9999 | Other dental service | 141 | $2,780 | 0.3% | $20 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 53 | $2,202 | 0.2% | $42 |
| D1354 | Interim caries arresting treatment — applying medicine to stop a cavity from growing | 121 | $1,103 | 0.1% | $9 |
| D0145 | Oral evaluation for a patient under 3 years old | 38 | $750 | 0.1% | $20 |
| D1208 | Dental preventive care (cleaning, fluoride, sealant) | 48 | $430 | 0.0% | $9 |
| D0270 | Dental X-ray — bitewing (single film, checks for cavities between teeth) | 12 | $141 | 0.0% | $12 |
| D0603 | Dental exam, X-ray, or screening | 39 | $140 | 0.0% | $4 |
| D1330 | Dental preventive care (cleaning, fluoride, sealant) | 234 | $0 | 0.0% | $0 |
About This Data
This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.