Travis Ladel Fisher, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

683 Issued in SD

Practice address

5 4TH Ave E
Polson, MT 59860-2117

Phone

(406) 275-4904

Fax

(406) 275-4815

NPI assigned

May 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962617704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 4TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598602117",
            "telephone_number": "406-275-4904",
            "fax_number": "406-275-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 4TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598602117",
            "telephone_number": "406-275-4904",
            "fax_number": "406-275-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "TRAVIS",
        "middle_name": "LADEL",
        "name_prefix": "Mr.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "SD",
            "license": "683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen at Polson, L.L.C. (Polson Health and Rehabilitation Center)
• Fairbank Counseling, PLLC
• Coyote Fairbank, LCSW
• Shaina Lynn Fairbank, LCSW
• Sandra Fisher, PHARM. D.
• Michael J Flannery, MD
• Megan Elizabeth Fogle
• Naomi Elizabeth Foreman, RN, BSN
• Amelia Grace Forman, CPM, LM, DEM
• Timothy Fox, LAC

• Dental Hygienist in Polson, MT
• Providers in Polson, MT by specialty
• Dental Hygienist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.