CCPD LLC SOS Verified
4530 S CARSON ST STE 5, CARSON CITY, NV 89701
NPI Number
1134662679
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: CCPD LLC
Entity Number: E0440002016-4
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2016-10-06
Name Match: 95%
Registered Agent
Name: FREDERICK JOHN
Type: Non-Commercial Registered Agent
Address: 4530 S CARSON STREET, CARSON CITY, NV, 89701
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Mmember | Bluetree Dental LLC | 3605 Grant Dr, Reno, NV | Active |
Total Medicaid Payments
$4,523,994
+267% vs specialty average
Patients Seen
108,903
Total Claims
138,375
$ Per Patient
$42
Specialty avg: $40
Specialty Rank
#6 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 | $700,521 | |
| 2019 | $535,879 | |
| 2020 | $482,561 | |
| 2021 | $698,002 | |
| 2022 | $665,237 | |
| 2023 | $662,080 | |
| 2024 | $779,714 |
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 | 24,356 | $1,153,410 | 25.5% | $47 |
| D1120 | Dental cleaning for children (prophylaxis) | 21,366 | $1,069,692 | 23.6% | $50 |
| D0120 | Regular dental checkup and exam | 17,417 | $508,281 | 11.2% | $29 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 17,793 | $357,698 | 7.9% | $20 |
| D2930 | Stainless steel crown — prefabricated (primary tooth) | 2,523 | $202,885 | 4.5% | $80 |
| D2392 | Tooth-colored (resin) filling — two surfaces, back tooth | 3,831 | $192,719 | 4.3% | $50 |
| D0274 | Dental X-ray — bitewings (four films) | 6,547 | $132,751 | 2.9% | $20 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 4,286 | $123,596 | 2.7% | $29 |
| D1110 | Dental cleaning for adults (prophylaxis) | 2,661 | $116,012 | 2.6% | $44 |
| D0272 | Dental X-ray — bitewings (two films) | 6,216 | $112,250 | 2.5% | $18 |
| D9230 | Analgesia (pain management during dental work, like nitrous oxide/laughing gas) | 6,134 | $105,034 | 2.3% | $17 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 3,095 | $83,487 | 1.8% | $27 |
| D2391 | Tooth-colored (resin) filling — one surface, back tooth | 2,104 | $79,028 | 1.7% | $38 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 1,673 | $65,421 | 1.4% | $39 |
| D0220 | Single dental X-ray (of one tooth) | 5,052 | $60,906 | 1.3% | $12 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 1,827 | $59,218 | 1.3% | $32 |
| D1354 | Interim caries arresting treatment — applying medicine to stop a cavity from growing | 4,185 | $46,137 | 1.0% | $11 |
| D0230 | Additional dental X-ray | 4,049 | $20,369 | 0.5% | $5 |
| D0190 | Dental exam, X-ray, or screening | 1,036 | $14,191 | 0.3% | $14 |
| D0145 | Oral evaluation for a patient under 3 years old | 445 | $8,461 | 0.2% | $19 |
| D9215 | Local anesthesia (numbing injection for dental work) | 673 | $3,346 | 0.1% | $5 |
| D1208 | Dental preventive care (cleaning, fluoride, sealant) | 281 | $2,314 | 0.1% | $8 |
| D1510 | Space maintainer — device to hold space for a permanent tooth (fixed) | 24 | $1,752 | 0.0% | $73 |
| D9310 | Dental consultation — specialist opinion on a dental problem | 28 | $1,744 | 0.0% | $62 |
| D1353 | Dental preventive care (cleaning, fluoride, sealant) | 95 | $1,533 | 0.0% | $16 |
| D3220 | Pulp treatment for a baby tooth — removing infection from inside the tooth | 17 | $904 | 0.0% | $53 |
| D9420 | Hospital dental care — using the hospital for dental treatment (per hour) | 12 | $451 | 0.0% | $38 |
| D0160 | Dental exam, X-ray, or screening | 14 | $406 | 0.0% | $29 |
| D0240 | Dental X-ray of the whole mouth (panoramic) | 23 | $0 | 0.0% | $0 |
| D0350 | Dental exam, X-ray, or screening | 19 | $0 | 0.0% | $0 |
| D1330 | Dental preventive care (cleaning, fluoride, sealant) | 593 | $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.