Organization Active NPI

Sage Dental of Pompano Beach, P.a.

  • General Practice Dentistry
  • Pompano Beach, FL
National Provider Identifier
1477758191
Registry record updated Apr 19, 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 POMPANO BEACH, P.A.
Practice address
1650 N Federal Hwy
Suite 105
Pompano Beach, FL 33062-3200
Phone
(954) 946-4867
Fax
(561) 431-8169
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Authorized official

Name
Dr. 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

1650 N Federal Hwy
Suite 105
Pompano Beach, FL 33062-3200

Mailing address

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

National Provider Directory

National Provider Directory

Locations

1650 N Federal Hwy
Ste 105
Pompano Beach, FL 33062
Phone (844) 343-6853

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": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1477758191",
    "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": "1650 N FEDERAL HWY",
            "address_2": "SUITE 105",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623200",
            "telephone_number": "954-946-4867",
            "fax_number": "561-431-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF POMPANO BEACH, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2017-04-19",
        "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_name_prefix": "Dr.",
        "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 Pompano Beach, FL

Sources for this page

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