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DR. KELLY ANN CUSACK DMD
NPI 1255904082
Student in an Organized Health Care Education/Training Program in Iowa City, IA

Active since July 20, 2021
801 NEWTON RD, IOWA CITY, IA 52242(319) 335-7440(319) 335-7451 Get Directions Write a Review

NPPES record last updated: May 21, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kelly Ann Cusack Dmd NPPES

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

DR. KELLY ANN CUSACK DMD (NPI 1255904082) is an individual student in an organized health care education/training program in Iowa City, Iowa, licensed in Iowa (RES-30681) and active in the NPI registry since July 2021. She maintains a secondary practice location in Alton.

NPPES Registry Identity

NPI1255904082
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. KELLY ANN CUSACKCredential: DMD
Location Address801 NEWTON RDIowa City, IA 52242-1001
Mailing Address322 Dental Science Bldg SIowa City, IA 52242-1001 · (319) 335-7440 · Fax (319) 335-7451
Phone(319) 335-7440
Fax(319) 335-7451
Sole ProprietorNo
Enumeration DateJuly 20, 2021
Last NPPES UpdateMay 21, 2024
NPPES CertifiedMay 13, 2024
✔ NPI 1255904082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IA · RES-30681
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedDentistTaxonomy 122300000X · License 019.033249 (IL)
801 NEWTON RD, Iowa City, IA 52242
Open in Google Maps ↗

Secondary Practice Location 1

Location 12800 College AveAlton, IL 62002-4700 · Phone (309) 370-3920

Other Providers at the Same Location NPPES 20

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

DR. JUSTIN WILLIAM NICHOLS D.D.S.
Student in an Organized Health Care Education/Training Program
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7440
DR. TENIOLA OMOPARIOLA DDS
Dentist
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7499
STEVEN DORRIS
Dentist (Oral and Maxillofacial Radiology)
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7440
AUSTIN HINKLE
Student in an Organized Health Care Education/Training Program
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7440
JADEN PATRICK HOLTON DDS
Student in an Organized Health Care Education/Training Program
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7440
YAA SERWAA ASUBONTENG BDS
Student in an Organized Health Care Education/Training Program
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7499
DR. MICHAEL PATRICK OWEN D.M.D.
Student in an Organized Health Care Education/Training Program
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7440
DR. MARAM EMAD JARADAT BDS
Dentist (General Practice)
801 NEWTON RD
IOWA CITY, IA 52242
Johnson County (319) 335-7440

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 Kelly Cusack's NPI number?

The NPI number for Kelly Cusack is 1255904082. It was assigned to this individual provider in the NPPES registry on July 20, 2021.

Where is Kelly Cusack located?

Kelly Cusack practices at 801 Newton Rd, Iowa City, IA 52242. The listed phone number is (319) 335-7440.

What is Kelly Cusack's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Kelly Cusack was last updated on May 21, 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.