CPD SOUTH MEADOWS LLC SOS Verified
5435 KIETZKE LN STE 100, RENO, NV 89511
NPI Number
1891441762
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: CPD SOUTH MEADOWS, LLC
Entity Number: E0085282018-7
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2018-02-20
Name Match: 95%
Registered Agent
Name: David Shackelton
Type: Non-Commercial Registered Agent
Address: 60 LONEPINE CT, Reno, NV, 89519
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Mmember | CPD South Meadows, LLC | 255 Glendale Ave., Suite 3, Sparks, NV | Active |
Total Medicaid Payments
$846,545
+16% vs specialty average
Patients Seen
3,529
Total Claims
6,875
$ Per Patient
$240
Specialty avg: $109
Specialty Rank
#3 of 20
Dentist, Oral and Maxillofacial Surgery providers in Nevada
Peer Average
$732,792
Average total for Dentist, Oral and Maxillofacial Surgery
Claims per Patient
1.9
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 | $222,319 | |
| 2023 | $617,609 | |
| 2024 | $6,617 |
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 |
|---|---|---|---|---|---|
| D7210 | Surgical tooth extraction — requires cutting into gum or removing bone | 3,090 | $488,950 | 57.8% | $158 |
| D7240 | Removal of an impacted tooth — completely bony (deeply stuck in jawbone) | 361 | $89,663 | 10.6% | $248 |
| D9223 | Other dental service | 951 | $81,931 | 9.7% | $86 |
| D9222 | Other dental service | 752 | $66,559 | 7.9% | $89 |
| D9310 | Dental consultation — specialist opinion on a dental problem | 957 | $54,542 | 6.4% | $57 |
| D7140 | Tooth extraction — pulling a tooth that has erupted | 325 | $47,302 | 5.6% | $146 |
| D0330 | Panoramic dental X-ray (full view of all teeth and jaw) | 412 | $11,118 | 1.3% | $27 |
| D7220 | Removal of an impacted tooth — soft tissue (stuck under the gums) | 27 | $6,480 | 0.8% | $240 |
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.