MEDICARE: DR. ALEXANDRA ELIZABETH TRAVIS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	063745	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	53099A	OTHER	NY	MEDICARE PIN
3	331833	OTHER	NY	MEDICARE OSCAR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295464980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA ELIZABETH TRAVIS DDS

Provider Business Mailing Address
First Line	:	38 SHAKER BAY RD
Second Line	:
City	:	LATHAM
State	:	NY
Zip	:	12110-1254
Country	:	US
Telephone Number	:	518-810-2843
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 STATE ST
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12304-2610
Country	:	US
Telephone Number	:	518-370-1441
Fax Number	:	518-395-9431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	07/22/2025

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