Dental Depot of 164TH & Portland PLLC
Dental Depot of 164TH & Portland PLLC was paid $546K by Medicaid between Mar 2023 and Dec 2024, across 19 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 17% of everything it billed.
OKLAHOMA CITY, OK 73013
Next to other General Practice Dentistry providers in Oklahoma
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 6,354 | $231K | |
| 2024incomplete | 9,377 | $315K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 17% | 741 | 445 | $92K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 11% | 460 | 164 | $60K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 11% | 344 | 240 | $58K |
| D1110 | Prophylaxis - adult | 9.7% | 1,139 | 1,063 | $53K |
| D0330 | Panoramic radiographic image | 9.7% | 1,072 | 999 | $53K |
| D0274 | Bitewings - four radiographic images | 8.2% | 1,449 | 1,391 | $45K |
| D0220 | Intraoral - periapical first radiographic image | 7.1% | 2,536 | 2,360 | $39K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.5% | 1,146 | 1,054 | $36K |
| D1206 | Topical application of fluoride varnish | 5.5% | 1,622 | 1,503 | $30K |
| D1120 | Dental cleaning, childProphylaxis - child | 4.7% | 866 | 807 | $26K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.0% | 2,809 | 2,165 | $22K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.6% | 947 | 875 | $20K |
7 more codes
| D0140 | Limited oral evaluation - problem focused | 2.0% | 362 | $11K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 53 | $1K |
| D0601 | <1% | 57 | $503.25 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 34 | $487.68 |
| D0272 | Bitewings - two radiographic images | <1% | 21 | $387.79 |
| D0602 | <1% | 40 | $356.85 | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 33 | $355.77 |
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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Dental Depot South | Oklahoma City, OK | $3.40M |
| Dental Depot Orthodontics Central Okc PLLC | Oklahoma City, OK | $3.31M |
| Dental Depot Orthodontics South PLLC | Oklahoma City, OK | $2.53M |
| Dental Depot of I-44 & Garnett, PLLC | Tulsa, OK | $1.34M |
| Dental Depot Orthodontics North Okc PLLC | Oklahoma City, OK | $1.22M |
| Dental Depot Orthodontics Yukon PLLC | Yukon, OK | $1.04M |
| Dental Depot of Del City, PLLC | Del City, OK | $438K |
| Dental Depot Orthodontics Tecumseh, PLLC | Norman, OK | $107K |
| Dental Depot of Arlington PLLC | Arlington, TX | $31K |
| Dental Depot Orthodontics Del City, PLLC | Del City, OK | $21K |
| Dental Depot of Blue Springs PLLC | Blue Springs, MO | $21K |
| Dental Depot of Independence, PLLC | Independence, MO | $6K |
| Dental Depot of Mustang, PLLC | Oklahoma City, OK | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.