NPIMap

Organization Active NPI

Sage Dental Group of Georgia, LLC

  • Dentist
  • Woodstock, GA
National Provider Identifier
1760129324
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SAGE DENTAL GROUP OF GEORGIA, LLC
Practice address
8265 Highway 92
Woodstock, GA 30189-6516
Phone
(561) 999-9650
NPI assigned
May 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Cindy Roark, DMD, MS
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

8265 Highway 92
Woodstock, GA 30189-6516

Mailing address

951 Broken Sound Pkwy NW Ste 250
Boca Raton, FL 33487-3506
Phone (561) 999-9650

Other names 1

  • SAGE DENTAL OF WOODSTOCK 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

8265 Highway 92
Woodstock, GA 30189

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1760129324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 BROKEN SOUND PKWY NW STE 250",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873506",
            "telephone_number": "561-999-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8265 HIGHWAY 92",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896516",
            "telephone_number": "561-999-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL GROUP OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "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",
        "authorized_official_credential": "DMD, MS"
    },
    "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 WOODSTOCK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.