Travis Hogan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012588 Issued in AZ

Practice address

3409 N 56TH St Ste B
Phoenix, AZ 85018-6150

Phone

(480) 947-4791

NPI assigned

Jul 15, 2019

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

Enrolled in TX

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

Locations

Interoperability endpoints

• Direct secure messaging: thogan277656@direct.phhs.org

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.

• Gerald P. Woodrow, D.D.S., LLC

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1386518165
  NPD

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1972155414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 N 56TH ST STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186150",
            "telephone_number": "480-947-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N 56TH ST STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186150",
            "telephone_number": "480-947-4791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21295 S Ellsworth Loop Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851429867",
            "country_code": "US",
            "telephone_number": "480-771-8190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lyn Hogan
• K. Carolyn Hogan, D.D.S.
• Kristen Nicole Hogan, FNP
• Rebecca Joyce Hogan, CPNP
• Tania Maria Hogan, NP
• Ronald J Hogg, M.D.
• Richard M Hogge, DMD
• Christy L Hogue, NP
• Renni Hogue
• John Hohl, LISAC

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.