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    OpenPayerNPI Medicare & MedicaidGrand Strand Pediatric Dentistry
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    Grand Strand Pediatric Dentistry — Billing Profile & Reimbursement Data

    NPI 1881800480 · Myrtle Beach, SC · Pediatric Dentistry

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    Grand Strand Pediatric Dentistry is a pediatric dentistry provider located in Myrtle Beach, South Carolina. This profile covers 0 Medicare and 26 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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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationGrand Strand Pediatric Dentistry
    Address3112 Dick Pond Road
    CityMyrtle Beach
    StateSC
    ZIP29588
    TaxonomyPediatric Dentistry
    NPI EnumeratedMay 14, 2007

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

    Payer SourceTotal Paid
    Medicaid$4M
    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.

    26 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2392Post 2 surface resin‑based composite5,810$100$603.8K
    D1120Prophylaxis–child14,320$40$501K
    D0120Periodic oral evaluation - established patient20,110$20$482.6K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients20,950$20$335.2K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth6,350$50$323.6K
    D1351Sealant - per tooth8,580$30$257.5K
    D0272N/A11,660$20$221.6K
    D2391Resin‑based composite – one surface, posterior2,540$90$218.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)2,340$90$214.9K
    D2930N/A1,590$130$205K

    Showing 1–10 of 26

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. South Carolina median

    26 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A581301,060$150$371.1K
    D2392Post 2 surface resin‑based composite16350520$100$175.3K
    D1120Prophylaxis–child40470600$30$156.7K
    D9248N/A4950920$70$126.1K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)44290380$90$125K
    D9230N/A422101,150$30$115.5K
    D2391Resin‑based composite – one surface, posterior41300270$80$110.5K
    D1351Sealant - per tooth17200840$30$108.9K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth38590850$50$104.9K
    D0120Periodic oral evaluation - established patient256101,060$20$100K

    Showing 1–10 of 26

    Nearby Providers

    Other providers in the same ZIP code as Grand Strand Pediatric Dentistry, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Young Talkers, LLCSCSpeech-Language Pathologist$0$6.7M
    Stephen PhillipsSCOphthalmology Physician$5M$0
    Little River Medical Center, Inc.SCFederally Qualified Health Center (FQHC)$0$3.8M
    John HicksSCCardiovascular Disease Physician$870.3K$0
    Erol LaleSCCardiovascular Disease Physician$592.4K$0
    Christopher SkvarkaSCDermatology Physician$556.1K$0
    Nathan JonesSCDermatology Physician$408.2K$0
    Stephen BoatwrightSCPain Medicine (Anesthesiology) Physician$309.3K$0
    Brian AdlerSCInternal Medicine Physician$296.8K$0
    Richard OwensSCPhysical Therapist$287.1K$0

    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. South Carolina Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. South Carolina Distribution
    Grand Strand Pediatric Dentistry — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina