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

Dr. Kielan Dietrich, DMD

Individual provider Dentist · NPI 1992690812

Dr. Kielan Dietrich, DMD is a Dentist in Tahlequah, Oklahoma. Graduated from At Still University, Arizona School of Dentistry & Oral Hlth in 2025, 1 year ago. Licensed in Oklahoma.

Years since qualifying
1
Trained at
At Still University, Arizona School of Dentistry & Oral Hlth
Licensed in
OK
In the registry since
2025
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

19600 E Ross St
Tahlequah, OK 74464-0545
Phone: (539) 234-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 8114 (OK)

Record details

NPI number1992690812
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 11, 2025
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Medical schoolAT STILL UNIVERSITY, ARIZONA SCHOOL OF DENTISTRY & ORAL HLTH
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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