Sage Dental of Reunion Village

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF REUNION VILLAGE

Practice address

7975 Osceola Polk Line Rd
Davenport, FL 33896-9104

Phone

(863) 265-6182

NPI assigned

Mar 25, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cindy Roark, DMD, MS

Title

SVP & Chief Clinical Officer

Phone

(561) 999-9650

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1003566753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 CONGRESS AVE STE 150",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871213",
            "telephone_number": "561-999-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7975 OSCEOLA POLK LINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338969104",
            "telephone_number": "863-265-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF REUNION VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "SVP & CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-999-9650",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen J Ruiz, ARNP
• Jeffrey Ryan, PHARM D, RPH
• Myria J Ryan
• Sandra E Rynkowski, RN
• Yilena Sablon Hormigo
• Charlyne Louise Saint-Remy, PMHNP
• Maria Cristina Sainz de la Maza
• Edwin Manuel Salamanca, MD
• Magela Salgado Cervantes
• Joseph A Salhab, DO

• Dentist in Davenport, FL
• Providers in Davenport, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.