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DR. JOSE CARLOS DAUDT POLIDO DDS
NPI 1104912377
Dentist - Pediatric Dentistry in Los Angeles, CA

Active since October 05, 2006PECOS Enrolled
4650 W SUNSET BLVD, MS# 116, LOS ANGELES, CA 90027(323) 361-2130(323) 361-1090 Get Directions Write a Review

NPPES record last updated: March 18, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jose Carlos Daudt Polido Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOSE CARLOS DAUDT POLIDO DDS (NPI 1104912377) is an individual pediatric dentistry provider in Los Angeles, California, licensed in California (39870) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104912377
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. JOSE CARLOS DAUDT POLIDOCredential: DDS
Location Address4650 W SUNSET BLVD, MS# 116Los Angeles, CA 90027-6062
Mailing Address6430 W Sunset Blvd, Suite 600Los Angeles, CA 90028-7901 · (323) 361-4116 · Fax (323) 361-1090
Phone(323) 361-2130
Fax(323) 361-1090
Sole ProprietorNo
Enumeration DateOctober 5, 2006
Last NPPES UpdateMarch 18, 2013
✔ NPI 1104912377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in CA · 39870
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
4650 W SUNSET BLVD, Los Angeles, CA 90027
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Other Identifiers 1

MedicaidD39870CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jose Carlos Daudt Polido Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90027 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARK HENDRIK CORDEN M.D.
Pediatrics
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-8893
MS. ROBERTA MIYEKO KATO MD
Pediatrics (Pediatric Pulmonology)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-2101
CHILDREN'S HOSPITAL LOS ANGELES
General Acute Care Hospital (Children)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-3644
JESSICA ELIZABETH GREIM DPT, PT
Physical Therapist (Pediatrics)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (310) 361-2118
MOLLY CEVASCO PH.D., BCBA
Psychologist (Clinical Child & Adolescent)
4650 W SUNSET BLVD, MS #53
LOS ANGELES, CA 90027
Los Angeles County (323) 361-3849
GINNY KIM THAN NP
Nurse Practitioner (Pediatrics)
4650 W SUNSET BLVD, MS #81
LOS ANGELES, CA 90027
Los Angeles County (323) 361-3033
DOUGLAS SHAPIRO MD
Pediatrics (Pediatric Emergency Medicine)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 660-2450
ALEXANDRA LYNN JOSTES MD
Student in an Organized Health Care Education/Training Program
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-2122

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jose Polido's NPI number?

The NPI number for Jose Polido is 1104912377. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is Jose Polido located?

Jose Polido practices at 4650 W Sunset Blvd Ms# 116, Los Angeles, CA 90027. The listed phone number is (323) 361-2130.

What is Jose Polido's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Jose Polido enrolled in Medicare?

Yes. Jose Polido is registered in the Medicare PECOS enrollment system.

What insurance does Jose Polido accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 1 other insurer list Jose Polido as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jose Polido was last updated on March 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.