Active NPI
Carolyn S Kittell, D.D.S.
- Dentist
- Yukon, OK
National Provider Identifier
1154768299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6493
- Practice address
- 1315 S Holly Ave
Yukon, OK 73099-5407 - Phone
- (405) 354-4806
- NPI assigned
- May 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6493 | OK | Primary |
Addresses
Primary practice location
1315 S Holly Ave
Yukon, OK 73099-5407
Mailing address
1107 Fenwick PL
Nichols Hills, OK 73116-6409
Phone (405) 210-7175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150806010880 | CO | Order and Referring Only - Dentist | 9739493560 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6493 | OK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369872000000",
"number": "1154768299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 FENWICK PL",
"city": "NICHOLS HILLS",
"state": "OK",
"postal_code": "731166409",
"telephone_number": "405-210-7175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 S HOLLY AVE",
"city": "YUKON",
"state": "OK",
"postal_code": "730995407",
"telephone_number": "405-354-4806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTELL",
"first_name": "CAROLYN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-30",
"last_updated": "2013-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yukon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.