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    OpenPayerNPI Medicare & MedicaidMississippi Smiles Dentistry LLC
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    Mississippi Smiles Dentistry LLC — Billing Profile & Reimbursement Data

    NPI 1952710154 · Jackson, MS · General Practice Dentistry

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    Mississippi Smiles Dentistry LLC is a general practice dentistry provider located in Jackson, Mississippi. This profile covers 0 Medicare and 30 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
    OrganizationMississippi Smiles Dentistry LLC
    Address2189 Henry Hill Dr Ste A
    CityJackson
    StateMS
    ZIP39204
    TaxonomyGeneral Practice Dentistry
    NPI EnumeratedAugust 13, 2014

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

    Payer SourceTotal Paid
    Medicaid$10.2M
    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.

    30 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2930N/A10,830$120$1.3M
    D1351Sealant - per tooth51,620$30$1.3M
    D1120Prophylaxis–child48,920$30$1.3M
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients46,930$20$1M
    D2392Post 2 surface resin‑based composite10,700$100$1M
    D0120Periodic oral evaluation - established patient26,870$30$671.8K
    D0150Comprehensive oral evaluation – new or established patient17,440$30$575.6K
    D0272N/A22,680$20$340.3K
    D0330N/A10,440$30$313.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)4,050$80$303.4K

    Showing 1–10 of 30

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Mississippi median

    30 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A121601,130$90$267.6K
    D2392Post 2 surface resin‑based composite9360360$90$112.4K
    D2934N/A1430400$110$110.3K
    D1351Sealant - per tooth6320570$20$96.7K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)16330240$110$91K
    D1120Prophylaxis–child77401,040$20$79.8K
    D3220N/A45100330$60$70.1K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients6580640$20$57.5K
    D2391Resin‑based composite – one surface, posterior39290290$70$57.5K
    D0120Periodic oral evaluation - established patient7540530$20$53.8K

    Showing 1–10 of 30

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Mississippi Smiles Dentistry LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mississippi Smiles Dentistry LLCMSGeneral Practice Dentistry$0$2.4M
    William McalexanderMSDentist$0$1.5M
    Derek ClemmerMSDentist$0$1.5M
    Daniel JohnstonMSGeneral Practice Dentistry$0$1.3M

    Nearby Providers

    Other providers in the same ZIP code as Mississippi Smiles Dentistry LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jackson Hma LLCMSGeneral Acute Care Hospital$0$31M
    App Of Mississippi Ed, LLCMSEmergency Medicine Physician$0$17M
    Heritage Home Health AgencyMSHome Health Agency$0$6.3M
    Bio-medical Applications Of Mississippi, Inc.MSEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$4.1M
    Central Mississippi Civic Improvement Association, Inc.MSCommunity Health Worker$0$3.4M
    Isd Renal IncMSEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$2.6M
    River Oaks Management Company LLCMSFamily Medicine Physician$0$2.6M
    Trinity Pediatric ClinicMSPrimary Care Clinic/Center$0$2.4M
    Isd Renal IncMSEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$2M
    Mississippi Hma Hospitalists, LLCMSHospitalist Physician$0$1.3M

    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. Mississippi Providers
    4 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Mississippi Distribution
    Mississippi Smiles Dentistry LLC — 16 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Mississippi