Clinic
DR Wisdom Teeth
DR Wisdom Teeth was paid $15K by Medicaid between Jun 2020 and Mar 2024, across 5 billing codes. Its largest line is D7240, Removal of impacted tooth - completely bony — 35% of everything it billed.
33Billing provider infoDR WISDOM TEETH
SAN TAN VALLEY, AZ 85143
SAN TAN VALLEY, AZ 85143
33aNPI1992298533assigned 06/08/2018
33bProvider typeDental Clinic/Center
28Total paid$15K
24GClaims1,500
24DCodes billed5
24AFirst – last monthJun 2020 – Mar 2024
Compared with peers
Next to other Dental Clinic/Center providers in Arizona
Rank by total paid#30 of 70
Median peer was paid$7K
This provider vs. median2.2×
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 | |
|---|---|---|---|
| 2020 | 369 | $12K | |
| 2021 | 533 | $2K | |
| 2022 | 244 | $436.68 | |
| 2023 | 325 | $704.58 | |
| 2024incomplete | 29 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7240 | Removal of impacted tooth - completely bony | 35% | 84 | 28 | $5K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 33% | 140 | 60 | $5K |
| D0140 | Limited oral evaluation - problem focused | 16% | 695 | 582 | $2K |
| D0330 | Panoramic radiographic image | 16% | 553 | 503 | $2K |
| D9310 | <1% | 28 | 26 | $33.13 |
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 officialFENN, JEFFREY (OWNER)