NPIMap

Organization Active NPI

Sage Dental of East Deerfield Beach PLLC

  • Dentist
  • Deerfield Beach, FL
National Provider Identifier
1376204867
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SAGE DENTAL OF EAST DEERFIELD BEACH PLLC
Practice address
313 SE 15TH Ter
Deerfield Beach, FL 33441-4472
Phone
(954) 427-7513
NPI assigned
Jan 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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) 999-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

313 SE 15TH Ter
Deerfield Beach, FL 33441-4472

Mailing address

6600 Congress Ave Ste 150
Boca Raton, FL 33487-1213
Phone (561) 999-9650

Other names 1

  • Sage Dental of Deerfield Beach at The Cove Doing business as

National Provider Directory

National Provider Directory

Locations

313 SE 15th Ter
Deerfield Beach, FL 33441
Phone (954) 427-7513

Practitioners & affiliated clinicians

Practitioners 4

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": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1376204867",
    "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": "313 SE 15TH TER",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414472",
            "telephone_number": "954-427-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF EAST DEERFIELD BEACH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "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": "561-999-6500",
        "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": [
        {
            "organization_name": "Sage Dental of Deerfield Beach at The Cove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.