Active NPI
Antonela Polotanu, DDS
- General Practice Dentistry
- Bellevue, WA
National Provider Identifier
1982893020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00010919
- Practice address
- 1653 173Rd Ave NE
Bellevue, WA 98008-3120 - Phone
- (425) 246-4720
- NPI assigned
- Oct 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00010919 | WA | Primary |
Addresses
Primary practice location
1653 173Rd Ave NE
Bellevue, WA 98008-3120
Mailing address
1653 173Rd Ave NE
Bellevue, WA 98008-3120
Phone (425) 246-4720
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 |
|---|---|---|---|
| DE00010919 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1982893020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1653 173RD AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980083120",
"telephone_number": "425-246-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1653 173RD AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980083120",
"telephone_number": "425-246-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLOTANU",
"first_name": "ANTONELA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-15",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00010919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.