Carlye Zajicek Travis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6275 Issued in NE

Practice address

12113 W Center Rd
Omaha, NE 68144-3955

Phone

(402) 571-0475

Fax

(402) 571-2932

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carlye Travis DDS PC

  • Dental Clinic/Center
  • Omaha, NE
  • NPI 1548997703
  NPD Authorized official
• Irish Taylor Dental LLC

  • Dentist
  • Omaha, NE
  • NPI 1386876076
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659744000000",
    "number": "1265569305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12113 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443955",
            "telephone_number": "402-571-0475",
            "fax_number": "402-571-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12113 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443955",
            "telephone_number": "402-571-0475",
            "fax_number": "402-571-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "CARLYE",
        "middle_name": "ZAJICEK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Travaille
• Traveling Angels Inc.
• Daliyah J Travis-Mackins, CNA
• Alyssa Travis
• Bethany Travis, DO
• Freddie Travis
• Hydeia Latisha Travis
• Nikita Travis
• Nikeya Traynham
• Caitlin Treadaway

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.