Brandon Lewis Polk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8021 Issued in NC

Practice address

1101 Great Falls CT
Ste 102
Knightdale, NC 27545

Phone

(919) 415-1855

Fax

(919) 415-1849

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dani Stansell DDS PA 3

  • General Practice Dentistry
  • Knightdale, NC
  • NPI 1861078974
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1366529372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 GREAT FALLS CT",
            "address_2": "STE 102",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "27545",
            "telephone_number": "919-415-1855",
            "fax_number": "919-415-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GREAT FALLS CT",
            "address_2": "STE 102",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "27545",
            "telephone_number": "919-415-1855",
            "fax_number": "919-415-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "BRANDON",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366529372",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "9021T",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physician Services, P.C.
• Dustin R. Pierson, D.O.
• Cassie Pinder, M.S. CCC-SLP
• Dana Anne Pitzulo, PHARMD
• Timothy J Poirier, O.D.
• I-Asia Pope
• Power Healthcare LLC
• Hechu Li Prasada, MD
• Lindsay Ann Prettyman, DPT
• Prime Occupational Therapy PLLC

• General Practice Dentistry in Knightdale, NC
• Providers in Knightdale, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.