Healthcare Provider Details

I. General information

NPI: 1417828872
Provider Name (Legal Business Name): KATHERINE ELIZABETH TRAVIS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 KINMAN AVE
GOLETA CA
93117-3481
US

IV. Provider business mailing address

414 E COTA ST
SANTA BARBARA CA
93101-1624
US

V. Phone/Fax

Practice location:
  • Phone: 805-617-7898
  • Fax: 805-324-5177
Mailing address:
  • Phone: 805-617-7857
  • Fax: 805-618-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS112291
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS112291
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: