Jay Pietila, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600914 Issued in MI

Practice address

1550 W Quincy St
Hancock, MI 49930-1223

Phone

(906) 482-3621

NPI assigned

May 27, 2021

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1790351187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499300150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W QUINCY ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301223",
            "telephone_number": "906-482-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETILA",
        "first_name": "JAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James F Peterson, D.C.
• Sarah Pettibone, MD
• PH Copper Country Apothecaries LLC (Apothecary - Home Medical Equipment)
• PH Copper Country Apothecaries LLC (Copper Country Apothecary)
• PH Copper Country Apothecaries LLC (Apothecary Hancock)
• Madeline Pintar
• Kaitlin Plager, DO
• Gail Ploe
• Nicole Noel Polakowski, PT
• Portage Health Home Services, Inc.

• General Practice Dentistry in Hancock, MI
• Providers in Hancock, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.