Emporia Smiles Dba Elite Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

KS60593 Issued in KS

Legal business name

EMPORIA SMILES DBA ELITE DENTAL

Practice address

1409 Stanton St
Emporia, KS 66801-6170

Phone

(620) 342-3600

Fax

(620) 340-8087

NPI assigned

Feb 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Chris W Polk, DDS

Title

Owner/President

Phone

(620) 342-3600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1518299080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 STANTON ST",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668016170",
            "telephone_number": "620-342-3600",
            "fax_number": "620-340-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 STANTON ST",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668016170",
            "telephone_number": "620-342-3600",
            "fax_number": "620-340-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPORIA SMILES DBA ELITE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "620-342-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "KS60593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Emporia, KS
• Providers in Emporia, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.