MEDICAL AND DENTAL CENTER OF NEVADA LLC SOS Verified
4275 BURNHAM AVE STE 101, LAS VEGAS, NV 89119
NPI Number
1215429030
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: MEDICAL AND DENTAL CENTER OF NEVADA LLC
Entity Number: E0185292018-9
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2018-04-16
Name Match: 95%
Registered Agent
Name: C T CORPORATION SYSTEM**
Type: Commercial Registered Agent
Address: 701 S CARSON ST STE 200, Carson City, NV, 89701
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Mmember | Devin Larsen | 9709 Lakeside Blvd, Ste 350, Spring, TX | Active |
| Mmember | Dennis Smythe | 9709 Lakeside Blvd, Ste 350, Spring, TX | Active |
Total Medicaid Payments
$5,997,716
+317% vs specialty average
Patients Seen
6,680
Total Claims
7,270
$ Per Patient
$898
Specialty avg: $286
Specialty Rank
#5 of 52
Clinic/Center, Ambulatory Surgical providers in Nevada
Peer Average
$1,437,364
Average total for Clinic/Center, Ambulatory Surgical
Claims per Patient
1.1
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 |
|---|---|---|
| 2019 | $337,008 | |
| 2020 | $845,010 | |
| 2021 | $1,025,003 | |
| 2022 | $906,216 | |
| 2023 | $1,116,902 | |
| 2024 | $1,767,577 |
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 |
|---|---|---|---|---|---|
| 41899 | Dental or mouth surgery — other procedure not listed elsewhere | 7,112 | $5,991,604 | 99.9% | $842 |
| D2930 | Stainless steel crown — prefabricated (primary tooth) | 80 | $4,867 | 0.1% | $61 |
| D9420 | Hospital dental care — using the hospital for dental treatment (per hour) | 15 | $554 | 0.0% | $37 |
| D1120 | Dental cleaning for children (prophylaxis) | 15 | $281 | 0.0% | $19 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 14 | $218 | 0.0% | $16 |
| D0230 | Additional dental X-ray | 21 | $116 | 0.0% | $6 |
| D0272 | Dental X-ray — bitewings (two films) | 13 | $75 | 0.0% | $6 |
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.