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MRS. KELSEY DIERIKX DDS
NPI 1740745728
Dentist - Oral and Maxillofacial Surgery in Iowa City, IA

Active since February 05, 2019Opted out of Medicare · through Jul 14, 2027
2814 NORTHGATE DR STE 2, IOWA CITY, IA 52245(319) 335-5484(319) 338-9413 Get Directions Write a Review

NPPES record last updated: August 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 20, 2019, Feb 5, 2019 (2 updates tracked since 2019).

About Mrs. Kelsey Dierikx Dds NPPES

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

MRS. KELSEY DIERIKX DDS (NPI 1740745728) is an individual oral and maxillofacial surgery provider in Iowa City, Iowa, licensed in Iowa (DDS-09677) and active in the NPI registry since February 2019. She has opted out of Medicare through July 14, 2027 and remains eligible to order and refer and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1740745728
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameMRS. KELSEY DIERIKXCredential: DDS
Location Address2814 NORTHGATE DR STE 2Iowa City, IA 52245-9505
Mailing Address322 Dental Science Bldg SIowa City, IA 52242-1001 · (319) 335-7440 · Fax (319) 335-7451
Phone(319) 335-5484
Fax(319) 338-9413
Sole ProprietorNo
Enumeration DateFebruary 5, 2019
Last NPPES UpdateAugust 4, 20232 updates tracked since enumeration
NPPES CertifiedAugust 3, 2023
✔ NPI 1740745728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in IA · DDS-09677
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.
Also ListedDentistTaxonomy 122300000X · License DDS-09677 (IA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2814 NORTHGATE DR STE 2, Iowa City, IA 52245
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1801 Newton RdIowa City, IA 52242-1001 · Phone (319) 335-7440 · Fax (319) 335-7451
Location 21804 E Washington StMT Pleasant, IA 52641-3217 · Phone (319) 385-5266 · Fax (319) 385-9142
Location 351300 Pomerantz Family Pavilion, 200 Hawkins DrIowa City, IA 52242-1049 · Phone (319) 356-2205 · Fax (319) 335-8956

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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

Mrs. Kelsey Dierikx 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 July 14, 2023 through July 14, 2027.

Opt-Out Effective DateJuly 14, 2023
Opt-Out In Effect ThroughJuly 14, 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 52245 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$66.36 typical visit price
range $16.91 – $131.98
Typical copayment $16.59 (range $4.22 – $32.99)
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.

TIMOTHY SCOTT ALBRIGHT D.D.S
Dentist (Oral and Maxillofacial Surgery)
2814 NORTHGATE DR STE 2
IOWA CITY, IA 52245
Johnson County (319) 338-5484

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 Kelsey Dierikx's NPI number?

The NPI number for Kelsey Dierikx is 1740745728. It was assigned to this individual provider in the NPPES registry on February 5, 2019.

Where is Kelsey Dierikx located?

Kelsey Dierikx practices at 2814 Northgate Dr Ste 2, Iowa City, IA 52245. The listed phone number is (319) 335-5484.

What is Kelsey Dierikx's specialty?

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

Is Kelsey Dierikx enrolled in Medicare?

No. Kelsey Dierikx has opted out of Medicare through July 14, 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.

What insurance does Kelsey Dierikx accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental of Iowa and 3 other insurers list Kelsey Dierikx 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 Kelsey Dierikx was last updated on August 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.