NPIMap

Organization Active NPI

Sage Dental Group of Georgia LLC

  • Dentist
  • Newnan, GA
National Provider Identifier
1497328397
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SAGE DENTAL GROUP OF GEORGIA LLC
Practice address
440 Newnan Crossing Byp Ste 102
Newnan, GA 30263-2476
Phone
(770) 776-5871
NPI assigned
Jul 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

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

Addresses

Primary practice location

440 Newnan Crossing Byp Ste 102
Newnan, GA 30263-2476

Mailing address

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

Other names 1

  • SAGE DENTAL OF NEWNAN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sage Dental Group of Georgia LLC25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

1605 Highway 34 E
Ste A1
Newnan, GA 30265
Phone (770) 254-8000

440 Newnan Crossing Byp
Ste 102
Newnan, GA 30263
Phone (770) 776-5871

166 Jefferson Pkwy
Newnan, GA 30263
Phone (770) 252-1300

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1497328397",
    "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": "440 NEWNAN CROSSING BYP STE 102",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632476",
            "telephone_number": "770-776-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL GROUP OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "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 NEWNAN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAGE DENTAL OF NEWNAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.