Individual provider Active NPI

James B Polley, D.D.S.

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1528237476
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2354 Issued in NV
Practice address
1875 Village Center Cir
#110
Las Vegas, NV 89134-6369
Phone
(702) 873-0324
Fax
(702) 873-6368
NPI assigned
Feb 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2354 NV Primary

Addresses

Primary practice location

1875 Village Center Cir
#110
Las Vegas, NV 89134-6369

Mailing address

1875 Village Center Cir
#110
Las Vegas, NV 89134-6369
Phone (702) 873-0324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150424001215 NV Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618296641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1528237476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 VILLAGE CENTER CIR",
            "address_2": "#110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346369",
            "telephone_number": "702-873-0324",
            "fax_number": "702-873-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 VILLAGE CENTER CIR",
            "address_2": "#110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346369",
            "telephone_number": "702-873-0324",
            "fax_number": "702-873-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLEY",
        "first_name": "JAMES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "2354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.