MEDICARE: DR. ALBINA POLT DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	049084	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	049084	OTHER	NY	DENTAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205826591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBINA POLT DDS

Provider Business Mailing Address
First Line	:	6610 YELLOWSTONE BLVD
Second Line	:	APT #4A
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2042
Country	:	US
Telephone Number	:	718-897-2955
Fax Number	:

Provider Business Practice Location Address
First Line	:	3753 91ST ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7901
Country	:	US
Telephone Number	:	718-205-4377
Fax Number	:	718-205-8605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	03/07/2023

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