MODERN DENTAL SPECIALIST, LLC SOS Verified
2560 S MARYLAND PKWY STE 5&6, LAS VEGAS, NV 89109
NPI Number
1487344032
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: Specialist. LLC
Entity Number: E37966212024-9
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2024-02-01
Status Changed: 2024-02-01
Name Match: 85%
Registered Agent
Name: Registered Agents Inc * (N)
Type: Commercial Registered Agent
Address: 732 S 6TH ST, STE R, Las Vegas, NV, 89101
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Mmember | Carolyn Land | 6311 Primrose Ave #19, Los Angeles, CA | Active |
| Mmember | Lillian Carrasquillo | 350 Cicadas Song Dr, Moncks Corner, SC | Active |
Total Medicaid Payments
$16,352
-69% vs specialty average
Patients Seen
695
Total Claims
771
$ Per Patient
$24
Specialty avg: $25
Specialty Rank
#4 of 6
Dentist, Endodontics providers in Nevada
Peer Average
$52,836
Average total for Dentist, Endodontics
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 |
|---|---|---|
| 2024 | $16,352 |
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 |
|---|---|---|---|---|---|
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 117 | $4,371 | 26.7% | $37 |
| D0274 | Dental X-ray — bitewings (four films) | 140 | $3,193 | 19.5% | $23 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 126 | $3,077 | 18.8% | $24 |
| D0220 | Single dental X-ray (of one tooth) | 163 | $2,073 | 12.7% | $13 |
| D7210 | Surgical tooth extraction — requires cutting into gum or removing bone | 30 | $1,938 | 11.9% | $65 |
| D0230 | Additional dental X-ray | 169 | $959 | 5.9% | $6 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 14 | $478 | 2.9% | $34 |
| D0120 | Regular dental checkup and exam | 12 | $262 | 1.6% | $22 |
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.