Active NPI
Travis Kettle, DDS
- Student in an Organized Health Care Education/Training Program
- Austin, TX
National Provider Identifier
1386344034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- E William Cannon Dr
Austin, TX 75219 - Phone
- (713) 894-7430
- NPI assigned
- Mar 9, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
E William Cannon Dr
Austin, TX 75219
Mailing address
3109 Douglas Ave Apt 210
Dallas, TX 75219-3535
Phone (713) 894-7430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1386344034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3109 DOUGLAS AVE APT 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752193535",
"telephone_number": "713-894-7430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "E WILLIAM CANNON DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "75219",
"telephone_number": "713-894-7430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTLE",
"first_name": "TRAVIS",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-09",
"last_updated": "2023-03-09",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.