Dental
Southpark Dentistry P.C.
Southpark Dentistry P.C. was paid $338K by Medicaid between Jul 2018 and Dec 2024, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 40% of everything it billed.
33Billing provider infoSOUTHPARK DENTISTRY P.C.
LITTLETON, CO 80120
LITTLETON, CO 80120
33aNPI1316472079assigned 05/01/2017
33bProvider typeDentist
28Total paid$338K
24GClaims10,932
24DCodes billed12
24AFirst – last monthJul 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in Colorado
Rank by total paid#96 of 344
Median peer was paid$45K
This provider vs. median7.5×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 809 | $23K | |
| 2019 | 1,880 | $51K | |
| 2020 | 1,315 | $37K | |
| 2021 | 1,567 | $45K | |
| 2022 | 1,978 | $60K | |
| 2023 | 1,984 | $61K | |
| 2024incomplete | 1,399 | $61K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 40% | 2,871 | 2,844 | $136K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 20% | 2,715 | 2,696 | $66K |
| D0274 | Bitewings - four radiographic images | 16% | 1,766 | 1,755 | $53K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.4% | 610 | 606 | $25K |
| D1206 | Topical application of fluoride varnish | 6.0% | 1,096 | 1,084 | $20K |
| D0220 | Intraoral - periapical first radiographic image | 3.9% | 1,047 | 1,026 | $13K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.1% | 429 | 425 | $10K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.9% | 203 | 203 | $6K |
| D0140 | Limited oral evaluation - problem focused | <1% | 76 | 75 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 17 | 13 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 17 | 12 | $2K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 85 | 84 | $2K |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialHERNANDEZ, BIANCA (OFFICE MANAGER)