NPIMap

Organization Active NPI

Sage Dental of Parkland, PLLC

  • General Practice Dentistry
  • Coral Springs, FL
National Provider Identifier
1104074004
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN6483 Issued in FL
Legal business name
SAGE DENTAL OF PARKLAND, PLLC
Practice address
5810 Coral Ridge Dr
Suite 130
Coral Springs, FL 33076-3374
Phone
(954) 905-1290
Fax
(561) 431-8169
NPI assigned
Sep 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
Antonio Cruz, DDS
Title
Chief Dental Director
Phone
(561) 999-9650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN6483 FL Primary

Addresses

Primary practice location

5810 Coral Ridge Dr
Suite 130
Coral Springs, FL 33076-3374

Mailing address

951 Broken Sound Pkwy
Suite 250
Boca Raton, FL 33487
Phone (561) 999-9650

National Provider Directory

National Provider Directory

Locations

5810 Coral Ridge Dr
Ste 130
Coral Springs, FL 33076
Phone (954) 905-1290

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1104074004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 BROKEN SOUND PKWY",
            "address_2": "SUITE 250",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33487",
            "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": "5810 CORAL RIDGE DR",
            "address_2": "SUITE 130",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763374",
            "telephone_number": "954-905-1290",
            "fax_number": "561-431-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF PARKLAND, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2017-03-17",
        "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": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN6483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.