Individual provider Active NPI

Sarah J Georges, DMD

  • General Practice Dentistry
  • Ponte Vedra Beach, FL
National Provider Identifier
1841783222
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN23403 Issued in FL
Practice address
100 Marketside Ave Ste 306
Ponte Vedra Beach, FL 32081-0582
Phone
(904) 810-5702
Fax
(904) 249-3109
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN23403 FL Primary

Addresses

Primary practice location

100 Marketside Ave Ste 306
Ponte Vedra Beach, FL 32081-0582

Mailing address

100 Marketside Ave Ste 306
Ponte Vedra Beach, FL 32081-0582
Phone (904) 810-5702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180803001817 FL Order and Referring Only - DentistPractitioner - Dentist 5890043087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Leaf Dental General Practice PastSince Dec 29, 2024 Accepting new patients

Organizations & group practices 1

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1841783222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARKETSIDE AVE STE 306",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320810582",
            "telephone_number": "904-810-5702",
            "fax_number": "904-249-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARKETSIDE AVE STE 306",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320810582",
            "telephone_number": "904-810-5702",
            "fax_number": "904-249-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGES",
        "first_name": "SARAH",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

Verify at the official NPI Registry.