DR. KATIE LOUISE PETERSON DDS
NPI 1124313143
Dentist in Bemidji, MN

Q: What is Katie Peterson's NPI number?

The NPI number for Katie Peterson is 1124313143. It was assigned to this individual provider in the NPPES registry on June 17, 2011.

Q: What is Katie Peterson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Katie Peterson was last updated on August 14, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since June 17, 2011PECOS Enrolled

1405 ANNE ST NW, NORTHERN DENTAL ACCESS CENTER, BEMIDJI, MN 56601(218) 444-9646(218) 444-9252 Get Directions Write a Review

NPPES record last updated: August 14, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Katie Louise Peterson Dds NPPES

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

DR. KATIE LOUISE PETERSON DDS (NPI 1124313143) is an individual dentist in Bemidji, Minnesota, licensed in Minnesota (D12931) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124313143

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. KATIE LOUISE PETERSONCredential: DDS

Location Address1405 ANNE ST NW, NORTHERN DENTAL ACCESS CENTERBemidji, MN 56601-5113

Mailing Address1405 Anne St Nw, Northern Dental Access CenterBemidji, MN 56601-5113 · (218) 444-9646 · Fax (218) 444-9252

Phone(218) 444-9646

Fax(218) 444-9252

Sole ProprietorNo

Enumeration DateJune 17, 2011

Last NPPES UpdateAugust 14, 2013

✔ NPI 1124313143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · D12931

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.

1405 ANNE ST NW, Bemidji, MN 56601

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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Katie Louise Peterson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56601 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MERITCARE MEDICAL GROUP

Optometrist