NPIMap

Organization Active NPI

Dale K Travis DDS PS

  • General Practice Dentistry
  • Woodinville, WA
National Provider Identifier
1932203502
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00005037 Issued in WA
Legal business name
DALE K TRAVIS DDS PS
Practice address
17416 135TH Ave NE
Ste 201
Woodinville, WA 98072
Phone
(425) 483-5959
Fax
(425) 806-5440
NPI assigned
Sep 12, 2006
Last updated
Jun 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Dale Kenneth Travis, DDSNPI 1184021297
Title
Dentist / Owner
Phone
(425) 483-5959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DE00005037 WA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DE00005037 WA Primary

Addresses

Primary practice location

17416 135TH Ave NE
Ste 201
Woodinville, WA 98072

Mailing address

PO Box 606
Woodinville, WA 98072
Phone (425) 483-5959

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1932203502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 606",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "425-483-5959",
            "fax_number": "425-806-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17416 135TH AVE NE",
            "address_2": "STE 201",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "425-483-5959",
            "fax_number": "425-806-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE K TRAVIS DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "425-483-5959",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00005037",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.