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General NPI Number Information
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NPI Number | 1295464980
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Entity Type | Individual
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Provider Name | ALEXANDRA ELIZABETH TRAVIS DDS
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Gender | Female
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1108 STATE ST
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City | SCHENECTADY
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State | NY
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Zip | 12304-2610
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Country | US
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Telephone | 518-370-1441
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Fax | 518-395-9431
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Provider Business Mailing Address
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Address Line | 38 SHAKER BAY RD
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City | LATHAM
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State | NY
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Zip | 12110-1254
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Country | US
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Telephone | 518-810-2843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 063745
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License Number State | NY
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