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    OpenPayerNPI Medicare & MedicaidDental Depot Southern Hills 71st & Jackson
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    Dental Depot Southern Hills 71st & Jackson — Billing Profile & Reimbursement Data

    NPI 1407412992 · Tulsa, OK · Dental Clinic/Center

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    Dental Depot Southern Hills 71st & Jackson is a dental clinic/center provider located in Tulsa, Oklahoma. This profile covers 0 Medicare and 35 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
    OrganizationDental Depot Southern Hills 71st & Jackson
    Address710 W 71st St
    CityTulsa
    StateOK
    ZIP74132
    TaxonomyDental Clinic/Center
    NPI EnumeratedMay 10, 2019

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

    Payer SourceTotal Paid
    Medicaid$4.3M
    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.

    35 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D7210Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…9,800$130$1.2M
    D2393Resin-based composite, three surfaces, posterior2,750$160$446K
    D2392Post 2 surface resin‑based composite2,940$120$338K
    D0330N/A5,200$50$249.6K
    D0220Intraoral - periapical first radiographic image14,850$20$222.8K
    D0274N/A7,270$30$217.9K
    D5214N/A220$960$212.4K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth4,180$40$184.1K
    D0230Intraoral - periapical each additional radiographic image21,870$10$174.9K
    D0120Periodic oral evaluation - established patient6,670$20$140.1K

    Showing 1–10 of 35

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Oklahoma median

    35 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D7240N/A4460340$210$328.8K
    D7210Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…5180450$120$188.3K
    D2392Post 2 surface resin‑based composite38330530$100$162.1K
    D2393Resin-based composite, three surfaces, posterior16190300$140$128.6K
    D5214N/A32040$950$98.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)139240280$70$91.8K
    D5213N/A31060$960$90.8K
    D5130N/A263030$850$77.9K
    D1120Prophylaxis–child68470730$30$77.5K
    D0120Periodic oral evaluation - established patient60540910$20$61.2K

    Showing 1–10 of 35

    Nearby Providers

    Other providers in the same ZIP code as Dental Depot Southern Hills 71st & Jackson, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Tulsa Spine & Specialty HospitalOKGeneral Acute Care Hospital$0$5.5M
    Medical Motion, L.L.C.OKDurable Medical Equipment & Medical Supplies$0$2.6M
    Vanguard Laboratory InnovationsOKClinical Medical Laboratory$2.4M$62.5K
    John SaurinoOKOphthalmology Physician$2.2M$0
    Olympia Anesthesia, PlcOKAnesthesiology Physician$0$1.8M
    Williams Medical Group Practice, LLCOKRural Health Clinic/Center$0$1.8M
    Osu Center For Health SciencesOKMedical Specialty Clinic/Center$0$1.7M
    Alison FischerOKDermatology Physician$490.5K$25.2K
    Hayley SewellOKPhysician Assistant$310.7K$0
    Kristin KingOKNeurology Physician$261.1K$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. Oklahoma Providers
    0 of 4 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Oklahoma Distribution
    Dental Depot Southern Hills 71st & Jackson — 7 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Oklahoma