Active NPI
Brien R. Polk, DDS
- Dentist
- Dyersburg, TN
National Provider Identifier
1902053135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8909
- Practice address
- 95 US Highway 51 Byp W
Dyersburg, TN 38024-1935 - Phone
- (731) 286-1271
- NPI assigned
- Aug 19, 2008
- Last updated
- Aug 14, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8909 | TN | Primary |
Addresses
Primary practice location
95 US Highway 51 Byp W
Dyersburg, TN 38024-1935
Mailing address
731 N Sampson Ave
Dyersburg, TN 38024-3961
Phone (731) 589-3621
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8909 | TN | MD | Nuclear Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376438400000",
"number": "1902053135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 N SAMPSON AVE",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380243961",
"telephone_number": "731-589-3621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 US HIGHWAY 51 BYP W",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241935",
"telephone_number": "731-286-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "BRIEN",
"middle_name": "R.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-19",
"last_updated": "2013-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "8909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyersburg, TN
- Ann Jannette R Pepito, PT
- Nerio Gomez Pepito, PT
- Phoenix Health and Wellness
- Physical Therapy of Dyersburg PC
- Jesse Marie Pitcher
- Powell Transportation Services
- Judy A Powell, CRNA
- Michael Prater, SLP
- Premise Health of Tennessee Medical PC (Dot Dyersberg Family Health Center)
- Jerry Edward Presley, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.