Individual provider Active NPI

Edward Saul Polsky, DDS

  • Dentist
  • Boynton Beach, FL
National Provider Identifier
1487813069
Registry record updated May 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
FL4005 Issued in FL
Practice address
8256 Jog Road
Boynton Beach, FL 33472
Phone
(561) 742-4255
Fax
(561) 742-4246
NPI assigned
Jun 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X FL4005 FL Primary

Addresses

Primary practice location

8256 Jog Road
Boynton Beach, FL 33472

Mailing address

8256 Jog Road
Boynton Beach, FL 33472
Phone (561) 742-4255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160425000499 FL Order and Referring Only - DentistPractitioner - Dentist 5092014100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL4005FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Dental Group LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463270400000",
    "number": "1487813069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8256 JOG ROAD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33472",
            "telephone_number": "561-742-4255",
            "fax_number": "561-742-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8256 JOG ROAD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33472",
            "telephone_number": "561-742-4255",
            "fax_number": "561-742-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSKY",
        "first_name": "EDWARD",
        "middle_name": "SAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2016-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "FL4005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.