Travis Ball

Primary specialty

DentistTaxonomy code 122300000X

License

DN31072 Issued in FL

Practice address

1508 W 10TH St
Laurel, MS 39440-2668

Phone

(601) 428-6093

Fax

(601) 428-6096

NPI assigned

Jun 16, 2016

Sex

Male

Sole proprietor

No

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.

• Tillery Dental Clinics, P.a.

  • General Practice Dentistry
  • Laurel, MS
  • NPI 1376656041
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MS

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

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 28, 2025.

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1508216888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 W 10TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402668",
            "telephone_number": "601-428-6093",
            "fax_number": "601-428-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 W 10TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402668",
            "telephone_number": "601-428-6093",
            "fax_number": "601-428-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN31072",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3879-16",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aspire Dental
• Jennifer Lynn Aultman, NP-C
• Lauren S Aycock, FNP
• Elise Bagley, LMFT
• Thomas James Bailey, MD
• Terry L. Bang, M.D.
• Vivek Barclay, MD
• Brett Robert Barlow, M.D.
• David Miguel Barnes
• Quindalyn M Barnett, LPN

• All providers in Laurel, MS
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.