Travia Clemons, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

BN123560 Issued in GA

Practice address

9596 Bentley Dr
Grovetown, GA 30813-0279

Phone

(706) 305-9560

NPI assigned

Aug 9, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1609607811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 FOX SPRING RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093097",
            "telephone_number": "229-669-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9596 BENTLEY DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308130279",
            "telephone_number": "706-305-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "TRAVIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "BN123560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicare Creative Solutions
• Christine Cole, LPC, LLC
• Everald Clarke, P.T.
• Maddison Clayton
• Mark Clayton
• Cassidy Clifford, OTR/L
• Stanley P. Coe, MD
• Nicole Coffey
• Christine Cole
• Virginia Cole

• Dentist in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.