Kacie Marie Culotta, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

29962 Issued in TX

Practice address

11671 Jollyville Rd Ste 204
Austin, TX 78759-4141

Phone

(512) 345-9973

NPI assigned

Jun 3, 2014

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 19, 2016 through May 19, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Austin Sleep and Airway Health PLLC

  • Dentist
  • Austin, TX
  • NPI 1700625704
  NPD Authorized official
• Latched Beginnings

  • Dental Clinic/Center
  • Austin, TX
  • NPI 1720827728
  NPD Authorized official
• Annmarie Olson DDS PA

  • General Practice Dentistry
  • Austin, TX
  • NPI 1578659520
  NPD (past)

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1104239615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11671 JOLLYVILLE RD STE 204",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594141",
            "telephone_number": "512-345-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11671 JOLLYVILLE RD STE 204",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594141",
            "telephone_number": "512-345-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULOTTA",
        "first_name": "KACIE",
        "middle_name": "MARIE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE DENTAL LICENSE NUMBER",
            "identifier": "29962",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kay A Culligan
• Mary Cathryn Cullinane, ANP
• James R Cullington, M.D.
• Aundrea Culliver
• Melissa Ann Cullum, MD
• Cultivate Behavioral Health and Education
• Cultural Compass Psychological Services, PLLC
• Culture in Mind
• Caroline Abbie Eleanor Culver
• Danina Lee Culver, P.T.

• Dentist in Austin, TX
• Providers in Austin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.