MEDICARE: POLLY S. MA, DDS, DMD, MSD, PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1275481418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLLY S. MA, DDS, DMD, MSD, PLLC

Provider Business Mailing Address
First Line	:	3340 NE 125TH ST STE 2
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4591
Country	:	US
Telephone Number	:	206-362-8314
Fax Number	:	206-363-6696

Provider Business Practice Location Address
First Line	:	3340 NE 125TH ST STE 2
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4591
Country	:	US
Telephone Number	:	206-362-8314
Fax Number	:	206-363-6696

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. POLLY MA
Credential	:	MA
Telephone Number	:	206-362-8314

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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