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DR. RANDOLPH THOMAS TRAVIS DMD
NPI 1407862626
Dentist - Pediatric Dentistry in Madisonville, KY

Active since July 31, 2006
1400 PRIDE AVENUE, MADISONVILLE, KY 42431(270) 821-7386(270) 821-7401 Get Directions Write a Review

NPPES record last updated: June 12, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Randolph Thomas Travis Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RANDOLPH THOMAS TRAVIS DMD (NPI 1407862626) is an individual pediatric dentistry provider in Madisonville, Kentucky, licensed in Kentucky (KY. 5141) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1407862626
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. RANDOLPH THOMAS TRAVISCredential: DMD
Location Address1400 PRIDE AVENUEMadisonville, KY 42431-9108
Mailing Address1400 Pride AvenueMadisonville, KY 42431-9108 · (270) 821-7386 · Fax (270) 821-7401
Phone(270) 821-7386
Fax(270) 821-7401
Sole ProprietorYes
Enumeration DateJuly 31, 2006
Last NPPES UpdateJune 12, 2008
✔ NPI 1407862626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in KY · KY. 5141✔ Licensed in KY · INDIANA 12010320A✔ Licensed in OH · OHIO 30.019661
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 5141 (KY)
1400 PRIDE AVENUE, Madisonville, KY 42431
Open in Google Maps ↗

Other Identifiers 3

Other45608965KY · Epsdt
Medicaid200265680 AIN
Medicaid600-51414KY

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VAUGHN ELLIOT BRUMMER D.D.S.
Dentist (Pediatric Dentistry)
1400 PRIDE AVENUE
MADISONVILLE, KY 42431
Hopkins County (270) 821-7386

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randolph Travis's NPI number?

The NPI number for Randolph Travis is 1407862626. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Where is Randolph Travis located?

Randolph Travis practices at 1400 Pride Avenue, Madisonville, KY 42431. The listed phone number is (270) 821-7386.

What is Randolph Travis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Randolph Travis was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.