Mariano Andres Polack, DDS, MS
NPI 1679773188ActiveIndividual· Dentist, Prosthodontics· Gainesville, VA
Opted out of Medicare from January 2019 to January 2027. Dentist, Prosthodontics (DDS, MS) in Gainesville, Virginia, licensed in VA, with an NPI issued in July 2007. Part D covered 105 prescriptions written in 2024, 67% of them generic. Keystone Dental Inc. was the largest of 2 companies reporting payments in 2025, $13,241 in all, mostly honoraria.
Overview
| NPI | 1679773188 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS, MS |
| Sole proprietor | No |
| NPI issued | Jul 23, 2007 |
| Last updated in NPPES | Jul 23, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Prosthodontics Primary | 1223P0700X | 0401410556 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Jan 3, 2019 – Jan 3, 2027 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
Part D prescriptions in 2024
| Prescriptions (claims) | 105 · 116 30-day fills |
|---|---|
| Patients | 73 |
| Total drug cost | $790.05 |
| Generic share | 67% of claims |
Industry payments (Open Payments)
- 2025$13,241 · 9 payments from 2 companies
- 2024$98,075 · 43 payments from 3 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Keystone Dental Inc. | $12,441 | 8 |
| Straumann USA LLC | $800.00 | 1 |
What the 2025 payments were for
- Honoraria$12,000 · 4 payments
- Education$800.00 · 1 payment
- Travel and Lodging$235.60 · 1 payment
- Entertainment$204.90 · 3 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Dentist, Prosthodontics providers in Gainesville
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