Individual provider Active NPI

Kathleen Anne Titterington Tritsch, DDS

  • Dentist
  • Kansas City, MO
National Provider Identifier
1154559235
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28678 Issued in TX
Practice address
825 Euclid
Kansas City, MO 64124
Phone
(816) 474-4920
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN013914 GA
Dentist 122300000X 28678 TX Primary

Addresses

Primary practice location

825 Euclid
Kansas City, MO 64124

Mailing address

5301 Aberdeen
Fairway, KS 66205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20210811001506 MO Practitioner - Dentist 3779987813 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013914GAMDDentist
28678TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Jul 12, 2021 Accepting new patients
Samuel U. Rodgers Health Center, Inc CurrentSince Jul 12, 2021 Accepting new patients

Locations

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1154559235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 ABERDEEN",
            "city": "FAIRWAY",
            "state": "KS",
            "postal_code": "66205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EUCLID",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64124",
            "telephone_number": "816-474-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITTERINGTON TRITSCH",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013914",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.