KDS SAFARI LLC SOS Verified
2381B RENAISSANCE DR, LAS VEGAS, NV 89119
NPI Number
1447030713
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: KDS Safari LLC
Entity Number: E35185672023-5
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2023-09-28
Status Changed: 2023-09-28
Name Match: 95%
Registered Agent
Name: Carla Cordova
Type: Non-Commercial Registered Agent
Address: 3600 N Buffalo Dr., Suite 110, Las Vegas, NV, 89129
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Mmember | Carla LaLande Cordova | 3600 N Buffalo Dr., Ste 110, Las Vegas, NV | Active |
Total Medicaid Payments
$299,437
-76% vs specialty average
Patients Seen
9,690
Total Claims
12,345
$ Per Patient
$31
Specialty avg: $40
Specialty Rank
#45 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 |
|---|---|---|
| 2024 | $299,437 |
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) | 1,821 | $73,655 | 24.6% | $40 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 1,817 | $58,728 | 19.6% | $32 |
| D0120 | Regular dental checkup and exam | 1,559 | $36,488 | 12.2% | $23 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 1,655 | $33,536 | 11.2% | $20 |
| D2392 | Tooth-colored (resin) filling — two surfaces, back tooth | 497 | $23,030 | 7.7% | $46 |
| D0272 | Dental X-ray — bitewings (two films) | 1,264 | $20,514 | 6.9% | $16 |
| D9230 | Analgesia (pain management during dental work, like nitrous oxide/laughing gas) | 595 | $9,312 | 3.1% | $16 |
| D2391 | Tooth-colored (resin) filling — one surface, back tooth | 264 | $8,629 | 2.9% | $33 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 184 | $6,890 | 2.3% | $37 |
| D0274 | Dental X-ray — bitewings (four films) | 280 | $5,903 | 2.0% | $21 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 160 | $5,586 | 1.9% | $35 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 159 | $4,347 | 1.5% | $27 |
| D2930 | Stainless steel crown — prefabricated (primary tooth) | 61 | $4,276 | 1.4% | $70 |
| D1353 | Dental preventive care (cleaning, fluoride, sealant) | 548 | $3,968 | 1.3% | $7 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 54 | $1,563 | 0.5% | $29 |
| D0220 | Single dental X-ray (of one tooth) | 110 | $1,036 | 0.3% | $9 |
| D0240 | Dental X-ray of the whole mouth (panoramic) | 31 | $728 | 0.2% | $23 |
| D1110 | Dental cleaning for adults (prophylaxis) | 12 | $567 | 0.2% | $47 |
| D0603 | Dental exam, X-ray, or screening | 461 | $259 | 0.1% | $1 |
| D0230 | Additional dental X-ray | 49 | $252 | 0.1% | $5 |
| D0602 | Dental exam, X-ray, or screening | 211 | $113 | 0.0% | $1 |
| D0601 | Dental exam, X-ray, or screening | 133 | $57 | 0.0% | $0 |
| D9986 | Other dental service | 420 | $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.