Individual provider Active NPI

Tracy M Kittrell, D.D.S.

  • Dentist
  • Iowa City, IA
National Provider Identifier
1548340656
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7074 Issued in IA
Practice address
1421 E College St
Iowa City, IA 52245-4410
Phone
(319) 338-3023
Fax
(319) 338-2284
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7074 IA Primary
General Practice Dentistry 1223G0001X 7074 IA

Addresses

Primary practice location

1421 E College St
Iowa City, IA 52245-4410

Mailing address

1421 E College St
Iowa City, IA 52245-4410
Phone (319) 338-3023

Other identifiers 1

IdentifierTypeStateIssuer
0033381MedicaidIA

Medicare participation

Medicare enrollment files
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 Jul 7, 2015 through Jul 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7074IAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1548340656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E COLLEGE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522454410",
            "telephone_number": "319-338-3023",
            "fax_number": "319-338-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E COLLEGE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522454410",
            "telephone_number": "319-338-3023",
            "fax_number": "319-338-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTRELL",
        "first_name": "TRACY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "7074",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7074",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033381",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.