CHILDREN'S DENTAL CARE INTERNATIONAL SOS Verified
1750 WHEELER PEAK DRIVE, LAS VEGAS, NV 89106
NPI Number
1083904767
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: CHILDREN'S DENTAL CARE INTERNATIONAL
Entity Number: C28184-2001
Entity Type: Domestic Nonprofit Corporation
Entity Status: Active
Formation Date: 2001-10-19
Status Changed: 2009-01-22
Name Match: 95%
Registered Agent
Name: DAWN L. MCCLELLAN
Type: Non-Commercial Registered Agent
Address: 5429 PAINTED SUNRISE DR, LAS VEGAS, NV, 89149
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Secretary | FAE HUTCHINSON | 35 EDGEWOOD DR, Hilton Head, SC | Active |
| President | DAWN MCCLELLAN | 29 Purple Martin Lane, Hilton Head Island, SC | Active |
| Director | MICHAEL PEQUEEN | 4471 Dean Martin Dr, Unit 4107, Las Vegas, NV | Active |
| Treasurer | Jack Moyer | 1 Taos Trail South, Corrales, NM | Active |
Campaign Contributions
$30,937Total Contributed
4Candidates Supported
Officer / Individual Matches
PEQUEEN, MICHAELProbable Match
Matched via officer: MICHAEL PEQUEEN (Director)
$23,328 across 25 contributions
| Candidate | Office | Party | Total | Count |
|---|---|---|---|---|
| LEE, SUSIE | U.S. House | DEM | $234,000 | 270 |
Michael PequeenProbable Match
Matched via officer: MICHAEL PEQUEEN (Director)
$3,000 across 4 contributions
| Candidate | Office | Party | Total | Count |
|---|---|---|---|---|
| Chris Giunchigliani | Governor | Democratic Party | $2,000 | 2 |
| Brian Knudsen | City of Las Vegas, City Council, Ward 1 | Democratic Party | $1,000 | 2 |
PEQUEEN, MICHAEL EVERETTProbable Match
Matched via officer: MICHAEL PEQUEEN (Director)
$3,609 across 2 contributions
| Candidate | Office | Party | Total | Count |
|---|---|---|---|---|
| LEE, SUSIE | U.S. House | DEM | $30,000 | 30 |
Michael PeQueenProbable Match
Matched via officer: MICHAEL PEQUEEN (Director)
$1,000 across 1 contribution
| Candidate | Office | Party | Total | Count |
|---|---|---|---|---|
| Howard Watts III | State Assembly, District 15 | Democratic Party | $1,000 | 1 |
Data Notice Campaign contribution matches are based on automated name matching against Nevada Secretary of State campaign finance records. Corporate matches compare registered business names. Officer matches compare individual names and may include false positives due to common names. Contributions are to Nevada state and local candidates only.
Total Medicaid Payments
$1,162,244
-6% vs specialty average
Patients Seen
43,912
Total Claims
57,139
$ Per Patient
$26
Specialty avg: $40
Specialty Rank
#20 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 |
|---|---|---|
| 2018 | $58,306 | |
| 2019 | $941,084 | |
| 2020 | $162,855 |
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 |
|---|---|---|---|---|---|
| D1120 | Dental cleaning for children (prophylaxis) | 6,924 | $270,157 | 23.2% | $39 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 6,854 | $210,538 | 18.1% | $31 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 3,168 | $89,835 | 7.7% | $28 |
| D2392 | Tooth-colored (resin) filling — two surfaces, back tooth | 1,679 | $72,056 | 6.2% | $43 |
| D0120 | Regular dental checkup and exam | 3,682 | $71,294 | 6.1% | $19 |
| D0272 | Dental X-ray — bitewings (two films) | 3,791 | $58,012 | 5.0% | $15 |
| D2930 | Stainless steel crown — prefabricated (primary tooth) | 870 | $54,652 | 4.7% | $63 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 2,426 | $50,298 | 4.3% | $21 |
| D0274 | Dental X-ray — bitewings (four films) | 2,011 | $40,774 | 3.5% | $20 |
| D9230 | Analgesia (pain management during dental work, like nitrous oxide/laughing gas) | 2,151 | $34,114 | 2.9% | $16 |
| D2391 | Tooth-colored (resin) filling — one surface, back tooth | 929 | $32,147 | 2.8% | $35 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 923 | $31,092 | 2.7% | $34 |
| D0350 | Dental exam, X-ray, or screening | 2,994 | $26,670 | 2.3% | $9 |
| D8660 | Braces or orthodontic treatment | 634 | $21,271 | 1.8% | $34 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 516 | $18,519 | 1.6% | $36 |
| D0603 | Dental exam, X-ray, or screening | 6,658 | $16,815 | 1.4% | $3 |
| D0240 | Dental X-ray of the whole mouth (panoramic) | 1,328 | $13,984 | 1.2% | $11 |
| D0220 | Single dental X-ray (of one tooth) | 1,094 | $11,100 | 1.0% | $10 |
| D8691 | Braces or orthodontic treatment | 319 | $8,535 | 0.7% | $27 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 271 | $8,048 | 0.7% | $30 |
| D9420 | Hospital dental care — using the hospital for dental treatment (per hour) | 176 | $6,148 | 0.5% | $35 |
| D0230 | Additional dental X-ray | 891 | $4,465 | 0.4% | $5 |
| D2331 | Tooth-colored (resin) filling — two surfaces, front tooth | 51 | $3,110 | 0.3% | $61 |
| D2393 | Tooth-colored (resin) filling — three surfaces, back tooth | 54 | $2,796 | 0.2% | $52 |
| D1999 | Dental preventive care (cleaning, fluoride, sealant) | 118 | $1,755 | 0.2% | $15 |
| D3120 | Root canal or dental pulp treatment | 143 | $1,686 | 0.1% | $12 |
| D9310 | Dental consultation — specialist opinion on a dental problem | 38 | $1,223 | 0.1% | $32 |
| D9999 | Other dental service | 116 | $1,150 | 0.1% | $10 |
| D9215 | Local anesthesia (numbing injection for dental work) | 37 | $0 | 0.0% | $0 |
| D1330 | Dental preventive care (cleaning, fluoride, sealant) | 6,293 | $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.