Sage Dental of Oviedo PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF OVIEDO PLLC

Practice address

3607 Aloma Ave
Oviedo, FL 32765

Phone

(321) 304-6777

Fax

(561) 431-8169

NPI assigned

Jan 23, 2015

Last updated

Apr 26, 2017By the provider in NPPES

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

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1669862025",
    "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": "3607 ALOMA AVE",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "321-304-6777",
            "fax_number": "561-431-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF OVIEDO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "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": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.