Mahadeep Virk DMD, MSD & Ellen Polsky DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAHADEEP VIRK DMD, MSD & ELLEN POLSKY DDS

Practice address

22530 SE 64TH PL Ste 130
Issaquah, WA 98027-5353

Phone

(253) 848-4000

Fax

(253) 604-4130

NPI assigned

Nov 19, 2024

Organization subpart

No

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

Authorized official

Name

Angie Metzger

Title

Billing Manager

Phone

(253) 219-5730

Specialties & licenses 2

Addresses

Other names 1

• Kids Choice Dental Of Issaquah Doing business as

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1699590174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710047",
            "telephone_number": "253-848-4000",
            "fax_number": "253-604-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22530 SE 64TH PL STE 130",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275353",
            "telephone_number": "253-848-4000",
            "fax_number": "253-604-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHADEEP VIRK DMD, MSD & ELLEN POLSKY DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "METZGER",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "253-219-5730"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Choice Dental Of Issaquah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Maganas
• Paul Michael Magedanz
• Jamie Magill, MA, LMHC
• Carleton Rogers Miller Magus, LAC, LMP
• Katja Violet Magus, N.D.
• Anne M Mai, MD
• Dave H Mai, PHARMD
• Synthia Mainayar, OD
• Manija Mainer
• Major I Care L.L.C., D.B.a. 20-20 Optical

• Pediatric Dentistry in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.