Zachary M Polonus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

LL-556-21 Issued in NV

Practice address

1700 W Charleston Blvd # Ms 7424
Las Vegas, NV 89102-2335

Phone

(702) 774-5175

Fax

(702) 774-2812

NPI assigned

Mar 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Shahri Dental Corp

  • General Practice Dentistry
  • Beverly Hills, CA
  • NPI 1760114268
  NPD

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1851976096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S BEVERLY DR STE 180",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124815",
            "telephone_number": "310-277-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W CHARLESTON BLVD # MS 7424",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022335",
            "telephone_number": "702-774-5175",
            "fax_number": "702-774-2812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 S Beverly Dr Ste 180",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902124815",
            "country_code": "US",
            "telephone_number": "310-277-3451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLONUS",
        "first_name": "ZACHARY",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108923",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "LL-556-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Polo Otano
• Grisel Polo-Castaneda
• Alexander Polo, DO
• Lisandra Home Polo
• Loren Polo
• Inga A Polyak, M.D.
• Cassandra Polydoor
• Raymond Polydoor II, COTA/L
• Elizabeth Poma, MSW, CADC-I
• Tuvaoinuuese Monica Pomale

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.