Individual provider Active NPI

Travis A Thompson, DMD

  • General Practice Dentistry
  • Montgomery, AL
National Provider Identifier
1578922191
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6320.C1 Issued in AL
Practice address
3439 B McGehee Road, Suite 22
Montgomery, AL 36111
Phone
(334) 288-1868
NPI assigned
Feb 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 6320.C1 AL Primary

Addresses

Primary practice location

3439 B McGehee Road, Suite 22
Montgomery, AL 36111

Mailing address

230 E 10TH St Ste 106
Anniston, AL 36207-5771
Phone (256) 741-7340

Other practice location 1

1700 6th Ave N
Bessemer, AL 35020-4849
Phone (205) 434-2031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180907002456 AL Order and Referring Only - DentistPractitioner - Dentist 5597015727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6320.C1ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. PastSince Jan 1, 2022 Accepting new patients
Mission Dental Mobile LLC PastSince Mar 12, 2024 Accepting new patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. PastSince Jan 17, 2022 Accepting new patients

Organizations & group practices 3

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": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1578922191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 10TH ST STE 106",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075771",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3439 B MCGEHEE ROAD, SUITE 22",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36111",
            "telephone_number": "334-288-1868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 6th Ave N",
            "address_purpose": "LOCATION",
            "city": "Bessemer",
            "state": "AL",
            "postal_code": "350204849",
            "country_code": "US",
            "telephone_number": "205-434-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TRAVIS",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6320.C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.