Mystie Pieters, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12010411A Issued in IN

Practice address

751 E Porter Ave
Suite 1
Chesterton, IN 46304-9110

Phone

(219) 929-9289

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chesterton Family Dental

  • Dental Clinic/Center
  • Chesterton, IN
  • NPI 1295219368
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1265656243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E PORTER AVE",
            "address_2": "SUITE 1",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049110",
            "telephone_number": "219-929-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 E PORTER AVE",
            "address_2": "SUITE 1",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049110",
            "telephone_number": "219-929-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETERS",
        "first_name": "MYSTIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010411A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Peppin
• Laura Peppin
• Victoria Lynn Peracki, FNP
• Donna Persin, PTA
• Ryan Michael Phelps, PHARMD
• Kaitlin J Pilipovic
• Pamela Piwinski, RBT
• Lillianna Pollnow
• Kara Polus
• Porter Health Services (Westchester Medical Group)

• Dentist in Chesterton, IN
• Providers in Chesterton, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.