Stride Dental Hub LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STRIDE DENTAL HUB LLC

Doing business as

Sanford Modern Dentistry

Practice address

5030 W State Road 46 Ste 1018
Sanford, FL 32771-9247

Phone

(407) 529-6814

NPI assigned

Apr 8, 2025

Organization subpart

Yes

Parent organization

STRIDE DENTAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Daniel Jimenez

Title

Chief Operating Officer

Phone

(407) 529-6814

Specialties & licenses 1

Addresses

Other names 1

• Sanford Modern Dentistry Doing business as

Tax ID family

Stride Dental Hub LLC2 organizations share this tax ID, including this one

Part of

Stride Dental Hub LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dentistry of Kissimmee

  • Dentist
  • Kissimmee, FL
  • NPI 1447066097
  NPD tax ID

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1104610617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8154 LAZY BEAR LN",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327929409",
            "telephone_number": "407-529-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 W STATE ROAD 46 STE 1018",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327719247",
            "telephone_number": "407-529-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRIDE DENTAL HUB LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STRIDE DENTAL GROUP LLC",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-529-6814"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Sanford, FL
• Providers in Sanford, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.