NPIMap

Organization Active NPI

Travis Kimathi DDS PC

Doing business as First Care Pediatric Dentistry

  • Pediatric Dentistry
  • Woodstock, GA
National Provider Identifier
1316207996
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN013750 Issued in GA
Legal business name
TRAVIS KIMATHI DDS PC
Doing business as
First Care Pediatric Dentistry
Practice address
375 Parkway 575
#100
Woodstock, GA 30188-6439
Phone
(770) 924-0424
Fax
(770) 592-0636
NPI assigned
May 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Dr. Travis Kimathi, DDSNPI 1053590331
Title
President
Phone
(770) 924-0424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DN013750 GA Primary

Addresses

Primary practice location

375 Parkway 575
#100
Woodstock, GA 30188-6439

Mailing address

375 Parkway 575
#100
Woodstock, GA 30188-6439
Phone (770) 924-0424

Other names 1

  • First Care Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1316207996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 PARKWAY 575",
            "address_2": "#100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886439",
            "telephone_number": "770-924-0424",
            "fax_number": "770-592-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 PARKWAY 575",
            "address_2": "#100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886439",
            "telephone_number": "770-924-0424",
            "fax_number": "770-592-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS KIMATHI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "KIMATHI",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-924-0424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Care Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.