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    OpenPayerNPI Medicare & MedicaidSmiles 4 Kids Blackfoot PLLC
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    Smiles 4 Kids Blackfoot PLLC — Billing Profile & Reimbursement Data

    NPI 1154799047 · Blackfoot, ID · Pediatric Dentistry

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    Smiles 4 Kids Blackfoot PLLC is a pediatric dentistry provider located in Blackfoot, Idaho. This profile covers 0 Medicare and 24 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
    OrganizationSmiles 4 Kids Blackfoot PLLC
    Address621 Jensen Grove Dr
    CityBlackfoot
    StateID
    ZIP83221
    TaxonomyPediatric Dentistry
    NPI EnumeratedSeptember 9, 2015

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

    Payer SourceTotal Paid
    Medicaid$564.9K
    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.

    24 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D1120Prophylaxis–child3,130$80$253.5K
    D0274N/A1,080$70$72.2K
    D2392Post 2 surface resin‑based composite900$70$63K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth1,050$50$53.4K
    D0150Comprehensive oral evaluation – new or established patient700$40$28.1K
    D2391Resin‑based composite – one surface, posterior520$40$19.8K
    D2930N/A330$60$18.6K
    D9420N/A20$870$16.5K
    D1351Sealant - per tooth2,850$1$11.4K
    D0210Intraoral - complete series of radiographic images60$150$8.2K

    Showing 1–10 of 24

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Idaho median

    24 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A3450750$70$171.2K
    D1120Prophylaxis–child39250180$60$143K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth80320310$80$80.8K
    D9420N/A3840180$150$80.8K
    D2392Post 2 surface resin‑based composite69190280$60$72.9K
    D0210Intraoral - complete series of radiographic images79120140$120$66K
    D0145N/A2430370$50$44K
    D0330N/A94170170$50$35.6K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)69110300$30$32.4K
    D2391Resin‑based composite – one surface, posterior50140270$40$27.9K

    Showing 1–10 of 24

    Nearby Providers

    Other providers in the same ZIP code as Smiles 4 Kids Blackfoot PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mvh Bmc LLCIDRural Health Clinic/Center$0$11.6M
    Bmh Inc.IDRural Health Clinic/Center$0$5.8M
    Camp Hippo Pediatric Therapy LLCIDOccupational Therapist$0$5.5M
    J&m Mental Health, Inc.IDSocial Worker$0$4.5M
    Bmh IncIDCritical Access Hospital$0$3.5M
    Bmh IncIDRural Health Clinic/Center$0$2.6M
    Bmh, Inc.IDSurgery Physician$0$2.3M
    Southeastern Idaho Developmental Center, Inc.IDDevelopmentally Disabled Services Day Training Agency$0$1.8M
    Titan Willow Operator LLCIDAssisted Living Facility$0$1.5M
    City Of BlackfootIDLand Ambulance$234.1K$785.5K

    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. Idaho Providers
    0 of 3 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Idaho Distribution
    Smiles 4 Kids Blackfoot PLLC — 0 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Idaho