Sage Dental of Doctor Phillips PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF DOCTOR PHILLIPS PLLC

Practice address

7341 W Sand Lake Rd
Suite 1065
Orlando, FL 32819-5310

Phone

(407) 781-0386

Fax

(561) 431-8169

NPI assigned

Apr 18, 2016

Organization subpart

No

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

Authorized official

Name

Antonio Cruz, DMD

Title

Chief Dental Director

Phone

(561) 999-9650

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shada Ghnaim, DMD

  • Dentist
  • Orlando, FL
  • NPI 1013579929
  NPD (past)

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1548614480",
    "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": "334873507",
            "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": "7341 W SAND LAKE RD",
            "address_2": "SUITE 1065",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195310",
            "telephone_number": "407-781-0386",
            "fax_number": "561-431-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF DOCTOR PHILLIPS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2017-04-26",
        "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_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sage Atlas LLC
• Sage Atlas LLC Dba Brightstar Care of E. Orlando / Lake Nona (BrightStar Care of E. Orlando/Lake Nona)
• Sage Dental of Alafaya (Sage Dental Kids of East Orlando)
• Sage Dental of Alafaya 2 PLLC
• Sage Dental of Avalon Park PLLC
• Sage Dental of Downtown Orlando PLLC
• Sage Dental of Eastside Orlando, PLLC
• Sage Dental of Lake Nona
• Sage Dental of Sodo PLLC
• Sage Dental of University PLLC

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

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