Polyviou Dental Corportation, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

POLYVIOU DENTAL CORPORTATION, INC.

Practice address

120 Newport Beach Drive, Suite 27
Newport Beach, CA 92660

Phone

(888) 607-5889

NPI assigned

Jul 9, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Fred Z Babaee

Title

Ceo

Phone

(803) 608-2743

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1649898388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NEWPORT BEACH DRIVE, SUITE 27",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "888-607-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NEWPORT BEACH DRIVE, SUITE 27",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "888-607-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLYVIOU DENTAL CORPORTATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "BABAEE",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-608-2743",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Fred@SimplyMobileDentistry.com",
            "affiliation": "N",
            "endpointDescription": "Private email",
            "address_1": "120 Newport Beach Drive, Suite 27",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Ann Pollard Johnson, LMFT LPCC
• Mary Elizabeth Pollaro, MED, AMFT
• Polny Chiropractic Corporation
• Bohdan Stephan Polny, D.C.
• Gayle Copeland Polsky, M.D.
• Marlene Melero Pompa
• Jason Pon, M.S.
• Christian-Jeff Mistica Pontiga
• Jessica Ann Poole
• Lisa Louise Popper, LMFT

• Dental Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.