Healthcare Provider Details

I. General information

NPI: 1396204418
Provider Name (Legal Business Name): TRAVIS LEPERA DMD, MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7661 W RAWSON AVE
FRANKLIN WI
53132-9199
US

IV. Provider business mailing address

7661 W RAWSON AVE 7661 W RAWSON AVENUE
WAUWATOSA WI
53213-1542
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-2040
  • Fax: 414-401-5950
Mailing address:
  • Phone: 414-401-5950
  • Fax: 414-401-5950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number1001994-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: