Individual provider Active NPI

Roslyn Travis-Stratton, D.D.S.

  • General Practice Dentistry
  • Harvey, IL
National Provider Identifier
1427179381
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019021392 Issued in IL
Practice address
31 W 155TH St
Harvey, IL 60426-3556
Phone
(708) 596-5177
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019021392 IL Primary

Addresses

Primary practice location

31 W 155TH St
Harvey, IL 60426-3556

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177

Other practice location 1

19767 Torrence Ave
Lynwood, IL 60411-7624
Phone (708) 596-5177

Other practice location 2

2555 W 79th St
Chicago, IL 60652-1729
Phone (773) 434-1515

Other practice location 3

713 E 142nd St
Dolton, IL 60419-1062
Phone (708) 596-5177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20241224000824 IN Practitioner - Dentist 1951613207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019021392ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthnet Inc CurrentSince Dec 4, 2024 Accepting new patients
Community Healthnet Inc CurrentSince Dec 4, 2024 Accepting new patients
Community Healthnet Inc Past Accepting new patients
Roslyn Travis Stratton D.D.S.,P.C. General Practice Past Accepting new patients

Locations

1021 W 5th Ave
Gary, IN 46402

3503 Martin Luther King Dr
Gary, IN 46409
Phone (219) 293-8843

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1427179381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19767 Torrence Ave",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "IL",
            "postal_code": "604117624",
            "country_code": "US",
            "telephone_number": "708-596-5177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2555 W 79th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606521729",
            "country_code": "US",
            "telephone_number": "773-434-1515",
            "fax_number": "773-434-1515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "713 E 142nd St",
            "address_purpose": "LOCATION",
            "city": "Dolton",
            "state": "IL",
            "postal_code": "604191062",
            "country_code": "US",
            "telephone_number": "708-596-5177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS-STRATTON",
        "first_name": "ROSLYN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.