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BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION

Student in an Organized Health Care Education/Training Program · LAS VEGAS, NV

1700 W CHARLESTON BLVD BLDG A, LAS VEGAS, NV 89102

NPI Number
1053414862
Street View of 1700 W CHARLESTON BLVD BLDG A, LAS VEGAS, NV 89102

Practice location · View on Google Maps

SOS Verification: Pending Review
Multiple SOS Matches
Total Medicaid Payments
$3,769,334
+200% vs specialty average
Patients Seen
113,885
Total Claims
170,755
$ Per Patient
$33
Specialty avg: $33
Specialty Rank
#1 of 3
Student in an Organized Health Care Education/Training Program providers in Nevada
Peer Average
$1,256,634
Average total for Student in an Organized Health Care Education/Training Program
Claims per Patient
1.5
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
2018$103,095
2019$673,936
2020$490,834
2021$661,037
2022$633,087
2023$604,715
2024$602,630

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
D1120Dental cleaning for children (prophylaxis)13,688$444,305
11.8%
$32
D1206Fluoride treatment — painted on teeth to prevent cavities14,394$381,536
10.1%
$27
D7140Tooth extraction — pulling a tooth that has erupted11,736$368,138
9.8%
$31
D0140Limited dental exam — for a specific problem (like a toothache)9,614$270,800
7.2%
$28
D0150Comprehensive dental exam — thorough check of teeth, gums, and mouth9,749$215,870
5.7%
$22
D1351Dental sealant — protective coating on a tooth to prevent cavities12,783$215,503
5.7%
$17
D3330Root canal — molar tooth1,044$212,293
5.6%
$203
D2930Stainless steel crown — prefabricated (primary tooth)3,820$161,572
4.3%
$42
D2950Crown buildup — rebuilding a broken tooth so a crown can be placed3,095$152,880
4.1%
$49
D0330Panoramic dental X-ray (full view of all teeth and jaw)5,834$143,828
3.8%
$25
D2392Tooth-colored (resin) filling — two surfaces, back tooth4,655$131,367
3.5%
$28
D0120Regular dental checkup and exam6,911$114,401
3.0%
$17
D2391Tooth-colored (resin) filling — one surface, back tooth4,800$112,296
3.0%
$23
D0272Dental X-ray — bitewings (two films)8,028$100,776
2.7%
$13
D9310Dental consultation — specialist opinion on a dental problem1,223$86,936
2.3%
$71
D0274Dental X-ray — bitewings (four films)5,076$84,881
2.3%
$17
D7210Surgical tooth extraction — requires cutting into gum or removing bone1,649$72,992
1.9%
$44
D9230Analgesia (pain management during dental work, like nitrous oxide/laughing gas)5,550$69,320
1.8%
$12
D0220Single dental X-ray (of one tooth)8,232$67,566
1.8%
$8
D0230Additional dental X-ray10,475$67,249
1.8%
$6
D0240Dental X-ray of the whole mouth (panoramic)9,542$62,348
1.7%
$7
D0190Dental exam, X-ray, or screening4,700$55,101
1.5%
$12
D8080Full braces (comprehensive orthodontic treatment, adolescent)19$25,549
0.7%
$1,345
D9248Other dental service327$22,703
0.6%
$69
D1110Dental cleaning for adults (prophylaxis)1,199$19,251
0.5%
$16
D8660Braces or orthodontic treatment630$17,491
0.5%
$28
D0340Dental exam, X-ray, or screening674$14,172
0.4%
$21
D9999Other dental service421$13,730
0.4%
$33
D1354Interim caries arresting treatment — applying medicine to stop a cavity from growing1,275$10,465
0.3%
$8
D0999Dental exam, X-ray, or screening298$9,220
0.2%
$31
D0270Dental X-ray — bitewing (single film, checks for cavities between teeth)1,823$8,667
0.2%
$5
D0350Dental exam, X-ray, or screening674$6,231
0.2%
$9
D0145Oral evaluation for a patient under 3 years old345$6,122
0.2%
$18
D3110Root canal or dental pulp treatment313$4,386
0.1%
$14
D0383Dental exam, X-ray, or screening250$3,266
0.1%
$13
D3220Pulp treatment for a baby tooth — removing infection from inside the tooth90$2,877
0.1%
$32
D0210Full set of dental X-rays95$2,503
0.1%
$26
D0601Dental exam, X-ray, or screening453$1,935
0.1%
$4
D2393Tooth-colored (resin) filling — three surfaces, back tooth127$1,335
0.0%
$11
D0602Dental exam, X-ray, or screening301$1,130
0.0%
$4
D4910Periodontal maintenance — follow-up cleaning after gum disease treatment1,998$1,078
0.0%
$1
D4341Deep cleaning (scaling and root planing) — per quadrant, 4+ teeth590$1,035
0.0%
$2
D1999Dental preventive care (cleaning, fluoride, sealant)69$1,035
0.0%
$15
D0460Dental exam, X-ray, or screening561$818
0.0%
$1
D4342Deep cleaning (scaling and root planing) — per quadrant, 1-3 teeth587$494
0.0%
$1
D2331Tooth-colored (resin) filling — two surfaces, front tooth112$379
0.0%
$3
D9110Emergency dental treatment — palliative (pain relief)17$347
0.0%
$20
D9239Other dental service12$278
0.0%
$23
D9243Other dental service12$271
0.0%
$23
D1208Dental preventive care (cleaning, fluoride, sealant)95$236
0.0%
$2
D2150Silver (amalgam) filling — two surfaces33$195
0.0%
$6
D0603Dental exam, X-ray, or screening160$128
0.0%
$1
D4346Gum disease treatment (periodontics)14$53
0.0%
$4
D1330Dental preventive care (cleaning, fluoride, sealant)531$0
0.0%
$0
D2740Crown (cap) — porcelain or ceramic14$0
0.0%
$0
D0391Dental exam, X-ray, or screening38$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.