Individual provider Active NPI

Amanda Romsa Polack, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Washington, DC
National Provider Identifier
1730494147
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DEN1001493 Issued in DC
Practice address
700 Pennsylvania Ave SE Ste 370
Washington, DC 20003-2552
Phone
(202) 899-5529
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019.028461 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN1001493 DC Primary

Addresses

Primary practice location

700 Pennsylvania Ave SE Ste 370
Washington, DC 20003-2552

Mailing address

700 Pennsylvania Ave SE Ste 370
Washington, DC 20003-2552
Phone (262) 497-4728

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DEN1001493DCMDOrthodontics and Dentofacial Orthopedic Dentist
019.028461ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
DC Braces PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Jun 15, 2025 Accepting new patients
Gallegos Dental, PLLC PastSince Oct 1, 2021 Accepting new patients

Locations

700 Pennsylvania Ave SE
Ste 370
Washington, DC 20003
Phone (202) 899-5529

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1730494147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 PENNSYLVANIA AVE SE STE 370",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032552",
            "telephone_number": "262-497-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PENNSYLVANIA AVE SE STE 370",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032552",
            "telephone_number": "202-899-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLACK",
        "first_name": "AMANDA",
        "middle_name": "ROMSA",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.028461",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "DC",
            "license": "DEN1001493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.