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MARY KAY DOERSCH DDS
NPI 1033220892
Dentist in Bluefield, WV

Active since August 31, 2006Opted out of Medicare · through Apr 16, 2027
1607 MARYLAND AVE, BLUEFIELD, WV 24701(304) 324-8703(304) 324-8735 Get Directions Write a Review

NPPES record last updated: October 24, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mary Kay Doersch Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY KAY DOERSCH DDS (NPI 1033220892) is an individual dentist in Bluefield, West Virginia, licensed in West Virginia (3246) and active in the NPI registry since August 2006. She has opted out of Medicare through April 16, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1033220892
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameMARY KAY DOERSCHCredential: DDS
Location Address1607 MARYLAND AVEBluefield, WV 24701
Mailing Address1607 Maryland AveBluefield, WV 24701 · (304) 324-8703 · Fax (304) 324-8735
Phone(304) 324-8703
Fax(304) 324-8735
Sole ProprietorNo
Enumeration DateAugust 31, 2006
Last NPPES UpdateOctober 24, 2012
✔ NPI 1033220892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WV · 3246
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1607 MARYLAND AVE, Bluefield, WV 24701
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Other Names 1

Other Name (5)Mrs. Mary Kay Clack

Other Identifiers 1

Medicaid4001019000WV

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mary Kay Doersch Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 16, 2015 through April 16, 2027.

Opt-Out Effective DateApril 16, 2015
Opt-Out In Effect ThroughApril 16, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CONKLIN & DOERSCH DDS INC
Dentist
1607 MARYLAND AVE
BLUEFIELD, WV 24701
Mercer County (304) 324-8703

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Doersch's NPI number?

The NPI number for Mary Doersch is 1033220892. It was assigned to this individual provider in the NPPES registry on August 31, 2006. The provider is also known as Mrs. Mary Kay Clack.

Where is Mary Doersch located?

Mary Doersch practices at 1607 Maryland Ave, Bluefield, WV 24701. The listed phone number is (304) 324-8703.

What is Mary Doersch's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Mary Doersch enrolled in Medicare?

No. Mary Doersch has opted out of Medicare through April 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Mary Doersch was last updated on October 24, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.