GLOWING SMILES LLC SOS Verified
1701 N GREEN VALLEY PKWY STE 5E, HENDERSON, NV 89074
NPI Number
1811652282
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: Glowing Smiles LLC
Entity Number: E18305552021-8
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2021-10-18
Status Changed: 2021-10-18
Name Match: 95%
Registered Agent
Name: Amy Tongsiri
Type: Non-Commercial Registered Agent
Address: 8108 Pebbleshire Ave, Las Vegas, NV, 89117
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | SMILE CONSULTANT LLC | 8108 Pebbleshire Ave, Las Vegas, NV | Active |
Total Medicaid Payments
$240,067
-81% vs specialty average
Patients Seen
7,079
Total Claims
10,958
$ Per Patient
$34
Specialty avg: $40
Specialty Rank
#48 of 98
Dentist, Pediatric Dentistry providers in Nevada
Peer Average
$1,233,441
Average total for Dentist, Pediatric Dentistry
Claims per Patient
1.5
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 |
|---|---|---|
| 2022 | $6,523 | |
| 2023 | $81,136 | |
| 2024 | $152,408 |
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) | 1,081 | $47,113 | 19.6% | $44 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 2,033 | $45,142 | 18.8% | $22 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 1,171 | $40,407 | 16.8% | $35 |
| D0230 | Additional dental X-ray | 2,871 | $29,450 | 12.3% | $10 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 594 | $18,604 | 7.7% | $31 |
| D0120 | Regular dental checkup and exam | 459 | $11,622 | 4.8% | $25 |
| D9248 | Other dental service | 124 | $11,043 | 4.6% | $89 |
| D0220 | Single dental X-ray (of one tooth) | 1,138 | $10,276 | 4.3% | $9 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 175 | $5,975 | 2.5% | $34 |
| D0274 | Dental X-ray — bitewings (four films) | 212 | $4,479 | 1.9% | $21 |
| D2392 | Tooth-colored (resin) filling — two surfaces, back tooth | 94 | $4,161 | 1.7% | $44 |
| D2930 | Stainless steel crown — prefabricated (primary tooth) | 38 | $2,979 | 1.2% | $78 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 57 | $1,835 | 0.8% | $32 |
| D9230 | Analgesia (pain management during dental work, like nitrous oxide/laughing gas) | 88 | $1,678 | 0.7% | $19 |
| D0272 | Dental X-ray — bitewings (two films) | 73 | $1,333 | 0.6% | $18 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 28 | $1,167 | 0.5% | $42 |
| D1353 | Dental preventive care (cleaning, fluoride, sealant) | 79 | $1,050 | 0.4% | $13 |
| D1208 | Dental preventive care (cleaning, fluoride, sealant) | 64 | $635 | 0.3% | $10 |
| D9999 | Other dental service | 12 | $600 | 0.2% | $50 |
| D0603 | Dental exam, X-ray, or screening | 483 | $442 | 0.2% | $1 |
| D0602 | Dental exam, X-ray, or screening | 84 | $78 | 0.0% | $1 |
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.