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    OpenPayerNPI Medicare & MedicaidKidspace Pediatric Dentistry Partnership
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    Kidspace Pediatric Dentistry Partnership — Billing Profile & Reimbursement Data

    NPI 1407561590 · Wichita, KS · Pediatric Dentistry

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    Kidspace Pediatric Dentistry Partnership is a pediatric dentistry provider located in Wichita, Kansas. This profile covers 0 Medicare and 25 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
    OrganizationKidspace Pediatric Dentistry Partnership
    Address430 N Woodlawn St
    CityWichita
    StateKS
    ZIP67208
    TaxonomyPediatric Dentistry
    NPI EnumeratedJanuary 23, 2023

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

    Payer SourceTotal Paid
    Medicaid$2.1M
    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.

    25 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2930N/A2,370$120$282.4K
    D2392Post 2 surface resin‑based composite3,140$80$248.3K
    D1120Prophylaxis–child6,550$30$202.9K
    D3220N/A2,570$60$156.7K
    D1351Sealant - per tooth5,180$30$139.7K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients7,510$20$135.1K
    D0120Periodic oral evaluation - established patient5,410$20$124.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)1,390$90$119.9K
    D2391Resin‑based composite – one surface, posterior1,640$70$119.5K
    D9420N/A1,030$100$98.7K

    Showing 1–10 of 25

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Kansas median

    25 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A24601,370$120$359.9K
    D1351Sealant - per tooth502101,490$20$189.4K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients34320590$30$120.1K
    D1120Prophylaxis–child32360540$40$108.9K
    D2392Post 2 surface resin‑based composite19190330$80$107.8K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)30130340$80$107.5K
    D3220N/A930540$60$96.1K
    D2391Resin‑based composite – one surface, posterior30170240$70$81K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth92340380$60$75.7K
    D0120Periodic oral evaluation - established patient39390560$20$68.5K

    Showing 1–10 of 25

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ascension Medical Group Via Christi, PAKSMulti-Specialty Clinic/Center$0$21.2M
    County Of SedgwickKSCase Manager/Care Coordinator$0$15.5M
    County Of SedgwickKSPsychiatry Physician$0$5.9M
    Great Plains Dental Group, LLCKSGeneral Practice Dentistry$0$5.8M
    Mental Health America Of South Central Kansas, Inc.KSCommunity/Behavioral Health Agency$0$5.7M
    Kidspace Pediatric Dentistry,p.aKSPediatric Dentistry$0$4.4M
    Cerebral Palsy Research Foundation Of Kansas, IncKSNon-emergency Medical Transport (VAN)$0$4.3M
    Nassim NabboutKSHematology & Oncology Physician$4.2M$0
    Phu TruongKSHematology & Oncology Physician$4.1M$0
    Grace Home Care, LLCKSHome Health Agency$0$4M

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