Kathleen McKay Travelle, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-5610 Issued in ID

Practice address

1529 S Timesquare LN
Boise, ID 83709-8266

Phone

(208) 314-1901

NPI assigned

Sep 23, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kathleen Lindsay McKay Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Koczarski Aesthetic & Laser Dentistry

  • Dental Clinic/Center
  • Woodinville, WA
  • NPI 1043763170
  NPD (past)
• Michael Koczarski DDS GPS PLLC

  • General Practice Dentistry
  • Woodinville, WA
  • NPI 1780523662
  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1487988580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098266",
            "telephone_number": "208-314-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098266",
            "telephone_number": "208-314-1901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17000 140th Ave NE",
            "address_2": "202",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980726928",
            "country_code": "US",
            "telephone_number": "425-486-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVELLE",
        "first_name": "KATHLEEN",
        "middle_name": "MCKAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60106324",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "MCKAY",
            "middle_name": "LINDSAY",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Transport 43 LLC
• Gregory T Trapp, M.D.
• James B Trapp, D.C.
• Kurt Trapp
• Kyley Jo Trausch, LCSW
• Shannon L Traver, LCPC
• L William Traverso, MD
• Travis Jay Kemp MD Inc
• Geonna Travis, RDN
• Brandon Trean, BCTMB

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.