Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kelly Ann Cusack, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1255904082

Dr. Kelly Ann Cusack, DMD is a Student in an Organized Health Care Education/Training Program in Iowa City, Iowa. Works from 2 locations. Licensed in Iowa and Illinois.

Licensed in
IA, IL
In the registry since
2021
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

801 Newton Rd
Iowa City, IA 52242-1001
Phone: (319) 335-7440
Fax: (319) 335-7451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2800 College Ave, Alton, IL 62002-4700 — (309) 370-3920

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence RES-30681 (IA)
Dentist Taxonomy 122300000X · Licence 019.033249 (IL)

Record details

NPI number1255904082
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 20, 2021
Last updated in NPPESMay 21, 2024
Certification dateMay 13, 2024

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