Sage Dental of Jacksonville Marietta PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF JACKSONVILLE MARIETTA PLLC

Practice address

8209 W Beaver St Ste 100
Jacksonville, FL 32220-2393

Phone

(561) 999-9650

NPI assigned

Sep 26, 2023

Organization subpart

No

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

Authorized official

Name

Cindy Roark

Title

SVP & Chief Clinical Officer

Phone

(561) 999-9650

Specialties & licenses 1

Addresses

Other names 1

• Sage Dental of Jacksonville Marietta PLLC Doing business as

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1285413575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931622",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8209 W BEAVER ST STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322202393",
            "telephone_number": "561-999-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF JACKSONVILLE MARIETTA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "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"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sage Dental of Jacksonville Marietta PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Eugene Safford, M.D.
• Seied Ali Safi, M.D.
• Loren Safille, MD
• Sage Dental of Jacksonville at Town Center PLLC
• Sage Dental of Jacksonville Glen Kernan, PLLC
• Sage Dental of Jacksonville Midtown PLLC
• Sage Dental of Jacksonville Southside PLLC
• Sandi Lea Sage, PH.D, LMHC
• Sagepoint Care Agency LLC
• Mylouse Millie Sagesse

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

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