TENDER DENTAL BONANAZA, LLC
5001 E BONANZA RD STE 160, LAS VEGAS, NV 89110
NPI Number
1124556741
Practice location · View on Google Maps
SOS Verification: Pending Review
Multiple SOS Matches
Total Medicaid Payments
$107,628
-74% vs specialty average
Patients Seen
3,669
Total Claims
5,725
$ Per Patient
$29
Specialty avg: $36
Specialty Rank
#97 of 248
Dentist, General Practice providers in Nevada
Peer Average
$419,652
Average total for Dentist, General Practice
Claims per Patient
1.6
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 | $43,444 | |
| 2019 | $5,701 | |
| 2020 | $776 | |
| 2021 | $57,707 | |
| 2022 | $0 |
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 |
|---|---|---|---|---|---|
| D7210 | Surgical tooth extraction — requires cutting into gum or removing bone | 897 | $35,315 | 32.8% | $39 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 1,323 | $28,642 | 26.6% | $22 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 725 | $10,434 | 9.7% | $14 |
| D0210 | Full set of dental X-rays | 429 | $9,077 | 8.4% | $21 |
| D0220 | Single dental X-ray (of one tooth) | 756 | $7,130 | 6.6% | $9 |
| D1120 | Dental cleaning for children (prophylaxis) | 197 | $2,778 | 2.6% | $14 |
| D2150 | Silver (amalgam) filling — two surfaces | 165 | $1,965 | 1.8% | $12 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 195 | $1,961 | 1.8% | $10 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 166 | $1,925 | 1.8% | $12 |
| D0230 | Additional dental X-ray | 330 | $1,838 | 1.7% | $6 |
| D7230 | Removal of an impacted tooth — partially bony (stuck in the jawbone) | 28 | $1,476 | 1.4% | $53 |
| D4355 | Gum disease treatment (periodontics) | 50 | $1,377 | 1.3% | $28 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 119 | $738 | 0.7% | $6 |
| D9994 | Other dental service | 70 | $574 | 0.5% | $8 |
| D9993 | Other dental service | 71 | $574 | 0.5% | $8 |
| D0274 | Dental X-ray — bitewings (four films) | 25 | $495 | 0.5% | $20 |
| D9310 | Dental consultation — specialist opinion on a dental problem | 20 | $430 | 0.4% | $22 |
| D5899 | Dentures or removable dental prosthetics | 80 | $369 | 0.3% | $5 |
| D0120 | Regular dental checkup and exam | 13 | $284 | 0.3% | $22 |
| D9420 | Hospital dental care — using the hospital for dental treatment (per hour) | 66 | $246 | 0.2% | $4 |
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.