Dental
Coffee Creek Pediatric Dentistry PLLC
Coffee Creek Pediatric Dentistry PLLC was paid $797K by Medicaid between Jan 2022 and Dec 2024, across 22 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 26% of everything it billed.
33Billing provider infoCOFFEE CREEK PEDIATRIC DENTISTRY PLLC
EDMOND, OK 73003
EDMOND, OK 73003
33aNPI1689331753assigned 11/23/2021
33bProvider typePediatric Dentist
28Total paid$797K
24GClaims30,534
24DCodes billed22
24AFirst – last monthJan 2022 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Oklahoma
Rank by total paid#18 of 32
Median peer was paid$804K
This provider vs. median1.0×
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 | |
|---|---|---|---|
| 2022 | 6,074 | $166K | |
| 2023 | 11,654 | $324K | |
| 2024incomplete | 12,806 | $307K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 26% | 1,756 | 481 | $211K |
| D1120 | Dental cleaning, childProphylaxis - child | 15% | 3,892 | 3,752 | $117K |
| D1206 | Topical application of fluoride varnish | 8.9% | 4,062 | 3,921 | $71K |
| D0220 | Intraoral - periapical first radiographic image | 7.8% | 4,140 | 3,962 | $62K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.5% | 2,829 | 2,732 | $60K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.6% | 6,820 | 3,740 | $53K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.4% | 320 | 198 | $35K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.3% | 1,139 | 1,082 | $34K |
| D0272 | Bitewings - two radiographic images | 4.1% | 1,816 | 1,731 | $33K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.9% | 1,146 | 972 | $31K |
| D7140 | Extraction, erupted tooth or exposed root | 2.4% | 289 | 138 | $19K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.4% | 207 | 103 | $19K |
10 more codes
| D1351 | Sealant - per tooth | 2.0% | 670 | $16K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.3% | 173 | $11K |
| D9310 | 1.1% | 177 | $8K | |
| D1110 | Prophylaxis - adult | <1% | 137 | $6K |
| D0603 | <1% | 418 | $4K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 82 | $2K |
| D0601 | <1% | 200 | $2K | |
| D0602 | <1% | 158 | $1K | |
| D0274 | Bitewings - four radiographic images | <1% | 38 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 65 | $975.36 |
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 officialFERGUSON, STEPHANIE (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Momentum Center,llc | Saint Cloud, MN | $776K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.