DR. MARYANN L UDY D.M.D.
NPI 1164650883
Dentist - Oral and Maxillofacial Surgery in O'fallon, MO

Active since July 01, 2009Opted out of Medicare · through Mar 27, 2028
5551 WINGHAVEN BLVD., STE 210, O'FALLON, MO 63368(636) 978-6967(636) 978-5905 Get Directions Write a Review

NPPES record last updated: May 1, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Maryann L Udy D.m.d. NPPES

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

DR. MARYANN L UDY D.M.D. (NPI 1164650883) is an individual oral and maxillofacial surgery provider in O'fallon, Missouri, licensed in Missouri (2013009771) and active in the NPI registry since July 2009. She has opted out of Medicare through March 27, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1164650883
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameDR. MARYANN L UDYCredential: D.M.D.
Location Address5551 WINGHAVEN BLVD., STE 210O'fallon, MO 63368
Mailing Address5551 Winghaven Blvd., Ste 210O'fallon, MO 63368 · (636) 978-6967 · Fax (636) 978-5905
Fax(636) 978-5905
Sole ProprietorNo
Enumeration DateJuly 1, 2009
Last NPPES UpdateMay 1, 2020
NPPES CertifiedMay 1, 2020
NPI 1164650883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in MO · 2013009771
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

5551 WINGHAVEN BLVD., STE 210, O'fallon, MO 63368

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Maryann L Udy D.m.d. 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 March 27, 2014 through March 27, 2028.

Opt-Out Effective DateMarch 27, 2014
Opt-Out In Effect ThroughMarch 27, 2028Opt-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 63368 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
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.

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 Maryann Udy's NPI number?

The NPI number for Maryann Udy is 1164650883. It was assigned to this individual provider in the NPPES registry on July 1, 2009.

Where is Maryann Udy located?

Maryann Udy practices at 5551 Winghaven Blvd., Ste 210, O'fallon, MO 63368. The listed phone number is (636) 978-6967.

What is Maryann Udy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Maryann Udy enrolled in Medicare?

No. Maryann Udy has opted out of Medicare through March 27, 2028. 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.

What insurance does Maryann Udy accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 11 other insurers list Maryann Udy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Maryann Udy was last updated on May 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.