Sage Dental of Brandon PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF BRANDON PLLC

Practice address

410 W Bloomingdale Ave
Brandon, FL 33511-7402

Phone

(813) 654-0037

NPI assigned

Dec 29, 2021

Organization subpart

No

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) 999-9650

Specialties & licenses 1

Addresses

Practitioners 3

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

• Susan Agnes Davidson, DDS

  • Dentist
  • Brandon, FL
  • NPI 1104544782
  NPD
• Sam Ayad Issa, BDS, HDD

  • Dentist
  • Brandon, FL
  • NPI 1720577505
  NPD
• Gary Royal Selby, DDS

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1982625323
  NPD (past)

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1417617689",
    "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": "410 W BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117402",
            "telephone_number": "813-654-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF BRANDON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "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": "561-999-9650",
        "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": []
}

• Farrukh Saeed, M.D.
• Courtney Safko, CHES
• Katarina Safko, APRN
• Sage Campione, Dcpa (Axis Chiropractic)
• Sage Dental of Brandon 2 PLLC
• Mrunmayi Sahasrabudhe, PT
• Ala F Sahawneh, M.D.
• Dhwanit Sahita
• Reena Saini
• Vijay Singh Saini, MD

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

• 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.