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DR. MARY THERESA BAUER DDS
NPI 1639234222
Dentist in Clarkston, MI

Active since December 26, 2006Opted out of Medicare · through Feb 20, 2028
5760 CLARKSTON ROAD, SUITE A, CLARKSTON, MI 48348(248) 625-9001 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Mary Theresa Bauer Dds NPPES

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

DR. MARY THERESA BAUER DDS (NPI 1639234222) is an individual dentist in Clarkston, Michigan, licensed in Michigan (2901012770) and active in the NPI registry since December 2006. She has opted out of Medicare through February 20, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1639234222
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. MARY THERESA BAUERCredential: DDS
Location Address5760 CLARKSTON ROAD, SUITE AClarkston, MI 48348
Mailing Address811 Hidden Pine RdBloomfield Hills, MI 48304-2410 · (248) 647-1097
Phone(248) 625-9001
Sole ProprietorNo
Enumeration DateDecember 26, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1639234222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MI · 2901012770
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.
5760 CLARKSTON ROAD, Clarkston, MI 48348
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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. Mary Theresa Bauer 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 February 20, 2008 through February 20, 2028.

Opt-Out Effective DateFebruary 20, 2008
Opt-Out In Effect ThroughFebruary 20, 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 48348 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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 Mary Bauer's NPI number?

The NPI number for Mary Bauer is 1639234222. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Where is Mary Bauer located?

Mary Bauer practices at 5760 Clarkston Road Suite A, Clarkston, MI 48348. The listed phone number is (248) 625-9001.

What is Mary Bauer's specialty?

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

Is Mary Bauer enrolled in Medicare?

No. Mary Bauer has opted out of Medicare through February 20, 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.

When was this NPI record last updated?

The NPPES record for Mary Bauer was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.