KACIE MARIE CULOTTA D.M.D.
NPI 1104239615
Dentist in Austin, TX

Q: What is Kacie Culotta's NPI number?

The NPI number for Kacie Culotta is 1104239615. It was assigned to this individual provider in the NPPES registry on June 3, 2014.

Q: What is Kacie Culotta's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Kacie Culotta enrolled in Medicare?

No. Kacie Culotta has opted out of Medicare through May 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Kacie Culotta was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 03, 2014Opted out of Medicare · through May 19, 2028

11671 JOLLYVILLE RD STE 204, AUSTIN, TX 78759(512) 345-9973 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Kacie Marie Culotta D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KACIE MARIE CULOTTA D.M.D. (NPI 1104239615) is an individual dentist in Austin, Texas, licensed in Texas (29962) and active in the NPI registry since June 2014. She has opted out of Medicare through May 19, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1104239615

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameKACIE MARIE CULOTTACredential: D.M.D.

Location Address11671 JOLLYVILLE RD STE 204Austin, TX 78759-4141

Mailing Address11671 Jollyville Rd Ste 204Austin, TX 78759-4141 · (512) 345-9973

Phone(512) 345-9973

Sole ProprietorNo

Enumeration DateJune 3, 2014

Last NPPES UpdateMay 22, 2024

NPPES CertifiedMay 22, 2024

✔ NPI 1104239615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in TX · 29962

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

11671 JOLLYVILLE RD STE 204, Austin, TX 78759

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Other Identifiers 1

Other29962TX · Texas State Dental License Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kacie Marie Culotta D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 19, 2016 through May 19, 2028.

Opt-Out Effective DateMay 19, 2016

Opt-Out In Effect ThroughMay 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78759 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$89.03 typical visit price

range $57.88 – $174.00

Typical copayment $22.25 (range $14.47 – $43.50)

Most-billed visit code 99203

Established Patient

$71.95 typical visit price

range $18.88 – $142.23

Typical copayment $17.98 (range $4.72 – $35.55)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LATCHED BEGINNINGS

Clinic/Center (Dental)

11671 JOLLYVILLE RD STE 204
AUSTIN, TX 78759

Travis County (512) 814-7480

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kacie Culotta's NPI number?

The NPI number for Kacie Culotta is 1104239615. It was assigned to this individual provider in the NPPES registry on June 3, 2014.

Where is Kacie Culotta located?

Kacie Culotta practices at 11671 Jollyville Rd Ste 204, Austin, TX 78759. The listed phone number is (512) 345-9973.

What is Kacie Culotta's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kacie Culotta enrolled in Medicare?

No. Kacie Culotta has opted out of Medicare through May 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Kacie Culotta accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 4 other insurers list Kacie Culotta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kacie Culotta was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.