Travis, Jillian Marie

Travis, Jillian Marie is an sole proprietor health care provider with primary practice located at 1213 W Nishna Rd , Shenandoah IA 51601-2115. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dental Hygienist. Dental Providers / Dental Hygienist is her primary health care specialty. Travis, Jillian Marie can be contacted via phone (712) 246-2180.

Contact Information

Primary practice address
1213 W Nishna Rd Shenandoah IA 51601-2115
Phone: (712) 246-2180
Fax: (712) 246-1683
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5587 Iowa
Dental Providers / Dental Hygienist 124Q00000X 2062 Iowa

Profile Details

NPI number 1821392457
LBN Legal business name Travis, Jillian Marie
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2010
Last updated May 20th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821392457 NPPES
Iowa MEDICAID 0062240
Iowa Other 1306926407

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