NORTHERN NEVADA DENTAL SPECIALTIES GROUP SOS Verified
10645 DOUBLE R BLVD, RENO, NV 89521
NPI Number
1720346117
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: NORTHERN NEVADA DENTAL SPECIALTIES GROUP LLC
Entity Number: E0174792012-0
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2012-03-28
Name Match: 90%
Registered Agent
Name: SHAY L WELLS
Type: Commercial Registered Agent
Address: 6100 NEIL RD STE 500, Reno, NV, 89511
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | BLUETREE DENTAL LLC | C/O WOODBURN AND WEDGE PO BOX 2311, RENO, NV, 89505 | Active |
Total Medicaid Payments
$9,317,045
+655% vs specialty average
Patients Seen
248,159
Total Claims
342,285
$ Per Patient
$38
Specialty avg: $40
Specialty Rank
#3 of 98
Dentist, Pediatric Dentistry providers in Nevada
Peer Average
$1,233,441
Average total for Dentist, Pediatric Dentistry
Claims per Patient
1.4
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 | $277,708 | |
| 2019 | $1,672,213 | |
| 2020 | $1,551,075 | |
| 2021 | $972,746 | |
| 2022 | $1,569,951 | |
| 2023 | $1,653,645 | |
| 2024 | $1,619,706 |
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) | 41,363 | $2,022,870 | 21.7% | $49 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 38,460 | $1,798,730 | 19.3% | $47 |
| D0120 | Regular dental checkup and exam | 35,626 | $1,016,855 | 10.9% | $29 |
| D2392 | Tooth-colored (resin) filling — two surfaces, back tooth | 12,532 | $541,536 | 5.8% | $43 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 27,392 | $530,060 | 5.7% | $19 |
| D2930 | Stainless steel crown — prefabricated (primary tooth) | 4,874 | $357,403 | 3.8% | $73 |
| D0272 | Dental X-ray — bitewings (two films) | 19,342 | $340,063 | 3.6% | $18 |
| D0220 | Single dental X-ray (of one tooth) | 22,686 | $299,009 | 3.2% | $13 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 9,705 | $266,159 | 2.9% | $27 |
| D0230 | Additional dental X-ray | 49,398 | $265,023 | 2.8% | $5 |
| D1110 | Dental cleaning for adults (prophylaxis) | 5,631 | $248,493 | 2.7% | $44 |
| D9223 | Other dental service | 6,242 | $241,690 | 2.6% | $39 |
| D2391 | Tooth-colored (resin) filling — one surface, back tooth | 7,150 | $241,467 | 2.6% | $34 |
| D9230 | Analgesia (pain management during dental work, like nitrous oxide/laughing gas) | 11,453 | $175,920 | 1.9% | $15 |
| D0274 | Dental X-ray — bitewings (four films) | 8,413 | $170,460 | 1.8% | $20 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 4,378 | $161,420 | 1.7% | $37 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 3,589 | $113,661 | 1.2% | $32 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 3,534 | $103,413 | 1.1% | $29 |
| D9222 | Other dental service | 1,621 | $83,847 | 0.9% | $52 |
| D9310 | Dental consultation — specialist opinion on a dental problem | 1,866 | $73,327 | 0.8% | $39 |
| D1208 | Dental preventive care (cleaning, fluoride, sealant) | 6,634 | $54,261 | 0.6% | $8 |
| D2393 | Tooth-colored (resin) filling — three surfaces, back tooth | 535 | $28,337 | 0.3% | $53 |
| D0999 | Dental exam, X-ray, or screening | 818 | $24,750 | 0.3% | $30 |
| D1354 | Interim caries arresting treatment — applying medicine to stop a cavity from growing | 2,802 | $23,253 | 0.2% | $8 |
| D9999 | Other dental service | 826 | $20,580 | 0.2% | $25 |
| D0145 | Oral evaluation for a patient under 3 years old | 1,146 | $19,917 | 0.2% | $17 |
| D9248 | Other dental service | 378 | $19,161 | 0.2% | $51 |
| D3220 | Pulp treatment for a baby tooth — removing infection from inside the tooth | 345 | $18,228 | 0.2% | $53 |
| D0270 | Dental X-ray — bitewing (single film, checks for cavities between teeth) | 1,882 | $17,818 | 0.2% | $9 |
| D0170 | Dental exam, X-ray, or screening | 685 | $9,010 | 0.1% | $13 |
| D0603 | Dental exam, X-ray, or screening | 3,519 | $8,820 | 0.1% | $3 |
| D9612 | Other dental service | 769 | $8,362 | 0.1% | $11 |
| D2929 | Dental filling, crown, or restoration | 55 | $6,315 | 0.1% | $115 |
| D1999 | Dental preventive care (cleaning, fluoride, sealant) | 228 | $3,390 | 0.0% | $15 |
| D2330 | Tooth-colored (resin) filling — one surface, front tooth | 33 | $1,297 | 0.0% | $39 |
| D1353 | Dental preventive care (cleaning, fluoride, sealant) | 134 | $1,066 | 0.0% | $8 |
| D3120 | Root canal or dental pulp treatment | 178 | $656 | 0.0% | $4 |
| D0191 | Dental exam, X-ray, or screening | 359 | $367 | 0.0% | $1 |
| D9210 | Other dental service | 283 | $31 | 0.0% | $0 |
| D9215 | Local anesthesia (numbing injection for dental work) | 96 | $18 | 0.0% | $0 |
| D1330 | Dental preventive care (cleaning, fluoride, sealant) | 5,325 | $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.