Jim H. Polles, D.M.D., P.a.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3402-06 Issued in MS

Legal business name

JIM H. POLLES, D.M.D., P.A.

Practice address

1836 Crane Ridge Dr
Suite a
Jackson, MS 39216-4901

Phone

(601) 362-1118

Fax

(601) 362-3113

NPI assigned

Sep 10, 2013

Last updated

Sep 10, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jim H Polles, D.M.D.NPI 1669482014

Title

Owner/Dentist

Phone

(601) 362-1118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Polles Center for General and Cosmetic Dentistry Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jim H Polles, D.M.D.

  • Dentist
  • Jackson, MS
  • NPI 1669482014
  NPD (past) Authorized official

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1720413768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 CRANE RIDGE DR",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164901",
            "telephone_number": "601-362-1118",
            "fax_number": "601-362-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 CRANE RIDGE DR",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164901",
            "telephone_number": "601-362-1118",
            "fax_number": "601-362-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM H. POLLES, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "POLLES",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "601-362-1118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MS",
            "license": "3402-06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00051807",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polles Center for General and Cosmetic Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicholas Barranco Jew, M.D.
• Disha Jhaveri, DMD
• Tulip Jhaveri, M.D.,
• Nathan Jia, MD
• Ahmad Jilani, MD
• Jmedinc
• Joe G. Collins, D.D.S., P.a.
• David Joe, MD
• John D. Isaacs Jr., M.D., P.a. (Mississippi Fertility Institute)
• John Elgin Wilkaitis, MD, Ms, PLLC (Children's Psychiatric Solutions)

• Dental Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.