MODERN DENTAL SPECIALIST, LLC SOS Verified
4618 MEADOWS LN, LAS VEGAS, NV 89107
NPI Number
1912607433
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
$94,319
+79% vs specialty average
Patients Seen
4,111
Total Claims
4,738
$ Per Patient
$23
Specialty avg: $25
Specialty Rank
#2 of 6
Dentist, Endodontics providers in Nevada
Peer Average
$52,836
Average total for Dentist, Endodontics
Claims per Patient
1.2
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 |
|---|---|---|
| 2023 | $36,230 | |
| 2024 | $58,089 |
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) | 630 | $22,691 | 24.1% | $36 |
| D0150 | Comprehensive dental exam — thorough check of teeth, gums, and mouth | 682 | $18,307 | 19.4% | $27 |
| D0274 | Dental X-ray — bitewings (four films) | 767 | $16,928 | 17.9% | $22 |
| D0220 | Single dental X-ray (of one tooth) | 915 | $10,864 | 11.5% | $12 |
| D1351 | Dental sealant — protective coating on a tooth to prevent cavities | 364 | $7,544 | 8.0% | $21 |
| D0230 | Additional dental X-ray | 1,005 | $5,774 | 6.1% | $6 |
| D1206 | Fluoride treatment — painted on teeth to prevent cavities | 115 | $3,609 | 3.8% | $31 |
| D1120 | Dental cleaning for children (prophylaxis) | 91 | $3,586 | 3.8% | $39 |
| D0140 | Limited dental exam — for a specific problem (like a toothache) | 81 | $2,679 | 2.8% | $33 |
| D7210 | Surgical tooth extraction — requires cutting into gum or removing bone | 73 | $2,099 | 2.2% | $29 |
| D0272 | Dental X-ray — bitewings (two films) | 15 | $238 | 0.3% | $16 |
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.