Individual provider Active NPI

Sabrina Stewart Lugo, DDS

  • Pediatric Dentistry
  • Clearwater, FL
National Provider Identifier
1720599897
Registry record updated Sep 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN28588 Issued in FL
Practice address
1180 Ponce de Leon Blvd Ste 401
Clearwater, FL 33756-1014
Phone
(727) 261-0304
Fax
(205) 271-6836
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN28588 FL Primary
Dentist 122300000X 6469 AL

Addresses

Primary practice location

1180 Ponce de Leon Blvd Ste 401
Clearwater, FL 33756-1014

Mailing address

1900 Crestwood Blvd Ste 211
Irondale, AL 35210-2056
Phone (205) 271-6841

Other names 1

  • Sabrina Alexa Stewart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6469ALMDDentist
DN28588FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Smiles Alabama II PC Dentist Past Accepting new patients
Vital Smiles Alabama, P.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1720599897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CRESTWOOD BLVD STE 211",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352102056",
            "telephone_number": "205-271-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 PONCE DE LEON BLVD STE 401",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337561014",
            "telephone_number": "727-261-0304",
            "fax_number": "205-271-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "SABRINA",
        "middle_name": "STEWART",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN28588",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SABRINA",
            "last_name": "STEWART",
            "middle_name": "ALEXA",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2023; 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.