Individual provider Active NPI

Robert Poli, D.M.D.

  • General Practice Dentistry
  • Salisbury, MD
National Provider Identifier
1730263732
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13938 Issued in MD
Practice address
3019 Merritt Mill Rd
Salisbury, MD 21804-1407
Phone
(410) 219-3366
Fax
(410) 219-3680
NPI assigned
Oct 25, 2006
Last updated
Oct 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI01256900 NJ
General Practice Dentistry 1223G0001X 035180 NY
General Practice Dentistry 1223G0001X 13938 MD Primary

Addresses

Primary practice location

3019 Merritt Mill Rd
Salisbury, MD 21804-1407

Mailing address

314 S Main St
Berlin, MD 21811-1406
Phone (201) 417-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13938MDMDGeneral Practice Dentistry
22DI01256900NJMDGeneral Practice Dentistry
035180NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1730263732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 S MAIN ST",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111406",
            "telephone_number": "201-417-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 MERRITT MILL RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041407",
            "telephone_number": "410-219-3366",
            "fax_number": "410-219-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLI",
        "first_name": "ROBERT",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01256900",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035180",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.