Healthcare Provider Details

I. General information

NPI: 1912460627
Provider Name (Legal Business Name): BRITTNEY KITTRELL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 HOUGH AVE
CLEVELAND OH
44103-4247
US

IV. Provider business mailing address

377 ATHENS WAY APT 409
NASHVILLE TN
37228-1378
US

V. Phone/Fax

Practice location:
  • Phone: 216-231-7700
  • Fax: 216-231-7920
Mailing address:
  • Phone: 248-797-1162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.026277
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: