NPIMap

Individual provider Active NPI

Stephen Michael Koveck, DDS

  • General Practice Dentistry
  • Chesterton, IN
National Provider Identifier
1386137388
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12012938A Issued in IN
Practice address
106 Indian Boundary Rd
Chesterton, IN 46304-1548
Phone
(219) 926-7595
NPI assigned
Jun 13, 2018
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12012938A IN Primary

Addresses

Primary practice location

106 Indian Boundary Rd
Chesterton, IN 46304-1548

Mailing address

106 Indian Boundary Rd
Chesterton, IN 46304-1548
Phone (219) 926-7595

Other practice location 1

11043 Broadway Ste A
Crown Point, IN 46307-8834
Phone (219) 663-4200

Other practice location 2

605 W Douglas Rd
Mishawaka, IN 46545
Phone (574) 277-2220

Other practice location 3

605 W Douglas Rd
Mishawaka, IN 46545
Phone (574) 277-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12012938AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Koveck Family Dentistry LLC Current Accepting new patients
Sleep Impressions, LLC Past Accepting new patients
Annette Williamson DDS, P.C. General Practice Past Accepting new patients
Affiliated Family Dentists PC Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1386137388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 INDIAN BOUNDARY RD",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463041548",
            "telephone_number": "219-926-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 INDIAN BOUNDARY RD",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463041548",
            "telephone_number": "219-926-7595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11043 Broadway Ste A",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463078834",
            "country_code": "US",
            "telephone_number": "219-663-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 W Douglas Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "46545",
            "country_code": "US",
            "telephone_number": "574-277-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 W Douglas Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "46545",
            "country_code": "US",
            "telephone_number": "574-277-2220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOVECK",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012938A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.