Kathryn Alexandra Polyakov, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20584 Issued in MA

Practice address

615 Concord St Ste 1
Framingham, MA 01702-8066

Phone

(508) 872-0045

Fax

(508) 281-1406

NPI assigned

Jun 9, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kathryn Polyakov DMD PC

  • Endodontics
  • Framingham, MA
  • NPI 1265580237

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1184883696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CONCORD ST STE 1",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017028066",
            "telephone_number": "508-872-0045",
            "fax_number": "508-281-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 CONCORD ST STE 1",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017028066",
            "telephone_number": "508-872-0045",
            "fax_number": "508-281-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYAKOV",
        "first_name": "KATHRYN",
        "middle_name": "ALEXANDRA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amrit Pokharel, OD
• Morgan Poli-Smith
• Stephanie Elizabeth Poli
• David Polidi
• Donna Polk
• Sarah Poolman, LMHC
• Michelle Marie Poor
• Ami Popat-Jain, MA
• Danielle Porcello
• Isabella Marie Porcello

• General Practice Dentistry in Framingham, MA
• Providers in Framingham, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.