NPIMap

Organization Active NPI

Travis Prunty DDS PLLC

  • Dental Clinic/Center
  • Mankato, MN
National Provider Identifier
1235395476
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D12552 Issued in MN
Legal business name
TRAVIS PRUNTY DDS PLLC
Practice address
730 E Madison Ave
Mankato, MN 56001-6100
Phone
(507) 388-3023
Fax
(507) 388-3353
NPI assigned
Aug 6, 2008
Last updated
Aug 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Travis Andrew PruntyNPI 1275685190
Title
DDS
Phone
(507) 388-3023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D12552 MN Primary

Addresses

Primary practice location

730 E Madison Ave
Mankato, MN 56001-6100

Mailing address

PO Box 894
Mankato, MN 56002-0894
Phone (507) 388-3023

National Provider Directory

National Provider Directory

Locations

730 Madison Ave
Mankato, MN 56001
Phone (507) 388-3023

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1235395476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 894",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560020894",
            "telephone_number": "507-388-3023",
            "fax_number": "507-388-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016100",
            "telephone_number": "507-388-3023",
            "fax_number": "507-388-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS PRUNTY DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "PRUNTY",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "507-388-3023",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.