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4G DENTAL PARTNERS SOS Verified

Clinic/Center, Dental · LAS VEGAS, NV

4235 E CHARLESTON BLVD, LAS VEGAS, NV 89104

NPI Number
1922569607
Street View of 4235 E CHARLESTON BLVD, LAS VEGAS, NV 89104

Practice location · View on Google Maps

SOS Verification: Verified
Entity Name: 4G DENTAL PARTNERS L.L.C.
Entity Number: E0013862019-2
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2019-01-10
Name Match: 90%
Registered Agent
Name: WYATT STOTT DANNELS
Type: Non-Commercial Registered Agent
Address: 612 CHERVIL VALLEY DR, LAS VEGAS, NV, 89138
Officers / Principals
TitleNameAddressStatus
ManagerWYATT DANNELS612 CHERVIL VALLEY DR, LAS VEGAS, NV, 89138Active
OtherYOUSSEF SALLOUM10425 E LARKSPUR DRIVE, Scottsdale, AZActive
Total Medicaid Payments
$82,879
-83% vs specialty average
Patients Seen
2,528
Total Claims
3,241
$ Per Patient
$33
Specialty avg: $33
Specialty Rank
#20 of 36
Clinic/Center, Dental providers in Nevada
Peer Average
$498,808
Average total for Clinic/Center, Dental
Claims per Patient
1.3
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$5,967
2024$76,912

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
D0210Full set of dental X-rays382$19,955
24.1%
$52
D0150Comprehensive dental exam — thorough check of teeth, gums, and mouth506$12,690
15.3%
$25
D7210Surgical tooth extraction — requires cutting into gum or removing bone272$12,254
14.8%
$45
D1351Dental sealant — protective coating on a tooth to prevent cavities434$8,650
10.4%
$20
D0274Dental X-ray — bitewings (four films)332$7,331
8.8%
$22
D1120Dental cleaning for children (prophylaxis)120$5,100
6.2%
$42
D0220Single dental X-ray (of one tooth)397$4,738
5.7%
$12
D2391Tooth-colored (resin) filling — one surface, back tooth77$3,265
3.9%
$42
D1110Dental cleaning for adults (prophylaxis)120$2,673
3.2%
$22
D0230Additional dental X-ray417$2,410
2.9%
$6
D0160Dental exam, X-ray, or screening53$1,375
1.7%
$26
D2392Tooth-colored (resin) filling — two surfaces, back tooth20$1,036
1.2%
$52
D0120Regular dental checkup and exam44$728
0.9%
$17
D1208Dental preventive care (cleaning, fluoride, sealant)53$566
0.7%
$11
D1206Fluoride treatment — painted on teeth to prevent cavities14$110
0.1%
$8

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.