WALDEMAR DAUDT POLIDO DDS, MS, PHD
NPI 1720529019
Oral & Maxillofacial Surgery in Indianapolis, IN

Q: What is Waldemar Daudt Polido's NPI number?

The NPI number for Waldemar Daudt Polido is 1720529019. It was assigned to this individual provider in the NPPES registry on March 20, 2017. The provider is also known as Waldemar D. Polido Dds, Ms, Phd.

Q: What is Waldemar Daudt Polido's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Active since March 20, 2017PECOS EnrolledAccepts Medicare Assignment

1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202(317) 278-3632 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 2, 2024, Mar 20, 2017 (2 updates tracked since 2017).

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About Waldemar Daudt Polido Dds, Ms, Phd NPPES

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

WALDEMAR DAUDT POLIDO DDS, MS, PHD (NPI 1720529019) is an individual oral & maxillofacial surgery provider in Indianapolis, Indiana, licensed in Indiana (98001085A) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health, and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1720529019

Entity TypeIndividualMale

Primary Taxonomy204E00000X

Provider Legal NameWALDEMAR DAUDT POLIDOCredential: DDS, MS, PHD

Location Address1121 W MICHIGAN STIndianapolis, IN 46202-5211

Mailing Address1121 W Michigan StIndianapolis, IN 46202-5211 · (317) 278-4456

Phone(317) 278-3632

Sole ProprietorNo

Medical School CMSOtherGraduated 1984

Enumeration DateMarch 20, 2017

Last NPPES UpdateAugust 25, 20252 updates tracked since enumeration

NPPES CertifiedAugust 25, 2025

✔ NPI 1720529019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code204E00000X

License✔ Licensed in IN · 98001085A

Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

1121 W MICHIGAN ST, Indianapolis, IN 46202

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Other Names 1

Professional Name (2)Waldemar D. Polido Dds, Ms, Phd

Secondary Practice Location 1

Location 1550 University Blvd Ste 3195Indianapolis, IN 46202-5149 · Phone (317) 274-7433 · Fax (317) 274-2603

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 and accepts Medicare assignment

Waldemar Daudt Polido Dds, Ms, Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698046340

PECOS Enrollment IDI20170731000820

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Indiana University Health

Acute Care Hospitals · Indianapolis, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150056

Location1701 N Senate BlvdIndianapolis, IN 46202 · Marion County

Emergency services Birthing friendly

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.

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