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General NPI Number Information
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NPI Number | 1972452399
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Entity Type | Organization
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Legal Business Name | VIRK DMD PS & POLSKY DDS LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 12600 SE 38TH ST STE 110
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City | BELLEVUE
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State | WA
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Zip | 98006-5232
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Country | US
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Telephone | 206-486-8068
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 460
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City | PUYALLUP
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State | WA
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Zip | 98371-0047
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Country | US
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Telephone | 206-486-8068
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MRS. RACHELLE BURGIN
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Credential |
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Telephone | 253-307-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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