Robert James Polking, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6422 Issued in IA

Practice address

851 S Taft Ave
Mason City, IA 50401-1503

Phone

(641) 424-9398

Fax

(641) 424-8130

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Polking & Polking, P.C.

  • General Practice Dentistry
  • Mason City, IA
  • NPI 1558528935
  NPD (past) Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811072150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S TAFT AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011503",
            "telephone_number": "641-424-9398",
            "fax_number": "641-424-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S TAFT AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011503",
            "telephone_number": "641-424-9398",
            "fax_number": "641-424-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLKING",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "6422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1161174",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "16117",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl J Plank, MD
• Brandon Plante, MD
• Tanusin Ploysangam, MD
• Michele Ann Plunkett, ARNP
• Polking & Polking, P.C.
• Sorin Popescu, MD
• David William Popp, MD
• Eric J Potthoff, D.O.
• Aileen R Prabhakaran, MD
• Sarah Prahm, APRN

• Dentist in Mason City, IA
• Providers in Mason City, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.