Jeffrey Polzin, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D13468 Issued in MN

Practice address

1225 E 1St St
Duluth, MN 55805-2402

Phone

(218) 728-6445

Fax

(218) 724-7003

NPI assigned

Jul 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

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.

• Lake Superior Dental Associates

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1871672584
  Medicare reassignment NPD
• Sla Dental PLLC

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1669894705
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1649687674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052402",
            "telephone_number": "218-728-6445",
            "fax_number": "218-724-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052402",
            "telephone_number": "218-728-6445",
            "fax_number": "218-724-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZIN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13468",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MN",
            "license": "D13468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Jean Pokorny, RPH, PHARMD
• Polinsky Medical Rehabilitation Center
• Mallory Polivka, M.A., R-DMT
• Nicholas David Polovitz, LGSW
• Kayla Polson, MSED, LPCC
• Julie A Polzin
• Kristina Marie Polzin, L.AC
• Scott Alan Polzin, DDS
• Brittany Pope-Sears
• Jean Eleanor Popelka, PTA

• Dentist in Duluth, MN
• Providers in Duluth, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.