Sage Dental of Windermere PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF WINDERMERE PLLC

Practice address

5122 Dr Phillips Blvd
Orlando, FL 32819-3312

Phone

(407) 434-8344

Fax

(561) 431-8169

NPI assigned

Nov 18, 2014

Organization subpart

No

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

Authorized official

Name

Antonio Cruz, DMD

Title

Chief Dental Director

Phone

(561) 999-9650

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tavis M Sisson, D.M.D.

  • Endodontics
  • Orlando, FL
  • NPI 1497195549
  NPD (past)
• Kejia Julia Sun, DMD

  • General Practice Dentistry
  • Orlando, FL
  • NPI 1881115178
  NPD (past)
• Gregory Robert Urfrig, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Orlando, FL
  • NPI 1629136031
  NPD (past)

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1063818102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 BROKEN SOUND PKWY",
            "address_2": "STE 250",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873507",
            "telephone_number": "561-999-9650",
            "fax_number": "561-431-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 DR PHILLIPS BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328193312",
            "telephone_number": "407-434-8344",
            "fax_number": "561-431-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF WINDERMERE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CHIEF DENTAL DIRECTOR",
        "authorized_official_telephone_number": "561-999-9650",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sage Dental of Eastside Orlando, PLLC
• Sage Dental of Lake Nona
• Sage Dental of Sodo PLLC
• Sage Dental of University PLLC
• Sage Dental of Waterford Lakes PLLC
• Elizabeth Sager, MSN, ARNP, A-GNP-C
• Sagori Dental Inc. (Universal Dental Spa)
• Poulomi Saha
• Khamwatie Sahadeo
• Ariaunna Raquel Sahagun

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.