Thomas S. Poelman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102703 Issued in CA

Practice address

2100 W 3Rd St Ste 220
Los Angeles, CA 90057-1993

Phone

(213) 413-8742

NPI assigned

May 21, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1093372591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W 3RD ST STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W 3RD ST STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571993",
            "telephone_number": "213-413-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POELMAN",
        "first_name": "THOMAS",
        "middle_name": "S.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858383",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Mark Podell, M.D,
• Paulina Catherine Podgorny, MD
• Stacey Edwin Podkovik, D.O.
• Patricia Ann Poe
• Darin Makoto Poei
• Arthur Suren Poghosyan
• Elen Poghosyan
• Timur R Pogodin, M.D
• Lydia Pogorzelski
• Angela Nickolette Pogossian, MA

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.