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    v1.0.28
    OpenPayerNPI Medicare & MedicaidLegendary Smiles, P.C.
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    Legendary Smiles, P.C. — Billing Profile & Reimbursement Data

    NPI 1023463320 · Watford City, ND · Dental Clinic/Center

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    Legendary Smiles, P.C. is a dental clinic/center provider located in Watford City, North Dakota. This profile covers 0 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    • ModifiersCPT modifiers & usage
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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationLegendary Smiles, P.C.
    Address109 5th St Sw
    CityWatford City
    StateND
    ZIP58854
    TaxonomyDental Clinic/Center
    NPI EnumeratedApril 25, 2016

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$12.6K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    4 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients210$20$5K
    D0120Periodic oral evaluation - established patient190$30$5K
    D1120Prophylaxis–child60$40$2K
    D0150Comprehensive oral evaluation – new or established patient10$50$630

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other North Dakota providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. North Dakota median

    4 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D1120Prophylaxis–child5980360$40$48.3K
    D0120Periodic oral evaluation - established patient66120350$40$46.8K
    D0150Comprehensive oral evaluation – new or established patient5760250$50$27K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients57110230$20$23.6K

    Nearby Providers

    Other providers in the same ZIP code as Legendary Smiles, P.C., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mckenzie County Healthcare Systems IncNDCritical Access Hospital$0$1.2M
    Mckenzie County Ambulance ServiceNDLand Ambulance$103.4K$52.2K
    Mckenzie County Healthcare Systems IncNDRural Health Clinic/Center$0$105.9K
    Eyes By Design LtdNDOptometrist$0$102K
    Anova Family Health Center Inc.NDPrimary Care Clinic/Center$0$46.6K
    Wade Darr LLCNDChiropractor$0$42.6K
    Empowered Therapy By Tara Lorenz, PLLCNDClinical Social Worker$0$18.3K
    Jennifer FleckNDFamily Nurse Practitioner$14K$0
    Myers Chiropractic PLLCNDChiropractor$0$12.4K
    Danielle DemorrowNDDentist$0$2.9K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. North Dakota Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. North Dakota Distribution
    Legendary Smiles, P.C. — 0 of 4 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Dakota