Sage Dental of Vero Beach PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAGE DENTAL OF VERO BEACH PLLC

Practice address

1960 25TH Ave Ste 101
Vero Beach, FL 32960-3015

Phone

(561) 999-9650

NPI assigned

Jun 1, 2021

Last updated

Jun 8, 2023By 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

Cindy Roark, DMD, MS, CCO

Title

President

Phone

(561) 999-9650

Specialties & licenses 1

Addresses

Other names 1

• SAGE DENTAL OF VERO BEACH PLLC Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ghazwan Al Kubaisi

  • Dentist
  • Vero Beach, FL
  • NPI 1154987915
  NPD

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1770159766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 CONGRESS AVE STE 150",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871213",
            "telephone_number": "561-999-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 25TH AVE STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603015",
            "telephone_number": "561-999-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL OF VERO BEACH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-999-9650",
        "authorized_official_credential": "DMD, MS, CCO"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAGE DENTAL OF VERO BEACH PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SAGE DENTAL OF VERO BEACH PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Rye
• S-H Thirty-Five Opco - Vero Beach, LLC (Brookdale Vero Beach)
• Sa-PG-Vero Beach LLC (Palm Garden of Vero Beach)
• Gabriela Sabanilla Trejo, MS, RDN, LDN
• Jeffrey Benjamin Sacks, M.D.
• Saint Teresa of Avila Healthcare PA (Saint Teresa of Avila Healthcare)
• Saphir Saint-Louis, RBT
• Tybule Saint-Louis
• Rosana Salama Bello, M.D.
• Leigh Ann Salamone, RDN

• Dentist in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.