Kelsey Dever, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09389 Issued in IA

Practice address

125 Scott St
Davenport, IA 52801-1130

Phone

(563) 336-3000

Fax

(563) 336-3229

NPI assigned

Jun 15, 2017

Last updated

Nov 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kelsey Biittner Other name

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kbiittner635369@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Davenport, IA
  • NPI 1932193224
  NPD (past)

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1316477094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SCOTT ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011130",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "527325726",
            "country_code": "US",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W River Dr",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528011014",
            "country_code": "US",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVER",
        "first_name": "KELSEY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031251",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DENTAL",
            "identifier": "019031251",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA DENTAL LICENSE",
            "identifier": "DDS-09389",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "BIITTNER",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaitlynn Ruth Dennis, RN
• Devan Louis Depauw, PA-C
• Kayla Depoorter
• Stephen P Deporter, APN
• Candace D Desmet
• Teri A. Devine, ARNP
• Katherine Ann Dewall
• Anthony B. Dexter, D.C.
• Deena Lynette Dhuse, LMSW
• Diamond Medical Spa and Vein, PC

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.

Verify at the official NPI Registry.