Sage Dental of Coconut Creek , PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN6483 Issued in FL

Legal business name

SAGE DENTAL OF COCONUT CREEK , PLLC

Practice address

5463 Lyons Rd
Suite C
Coconut Creek, FL 33073-2828

Phone

(954) 571-7123

Fax

(561) 431-8169

NPI assigned

Sep 4, 2008

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 Directors

Phone

(561) 999-9650

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1700034600",
    "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": "5463 LYONS RD",
            "address_2": "SUITE C",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732828",
            "telephone_number": "954-571-7123",
            "fax_number": "561-431-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF COCONUT CREEK , PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CHIEF DENTAL DIRECTORS",
        "authorized_official_telephone_number": "561-999-9650",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN6483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Rubin, LCSW
• Paviella K Ruether, LCSW
• Natalie Elaine Russo
• Ruthpro Incorporated
• Sagamore School, LLC
• Sage Womens Health, LLC
• Gurman K Sahi, DMD
• Guerlyne Saint- Jean, NURSE PRACTITIONER
• Jennaway Saintfleur
• Deborah Saland, PSYD, LCSW

• General Practice Dentistry in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.