NPIMap

Organization Active NPI

Sage Dental Group of Georgia, LLC

  • Dentist
  • Cumming, GA
National Provider Identifier
1982369542
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SAGE DENTAL GROUP OF GEORGIA, LLC
Doing business as
Sage Dental of North Cumming
Practice address
5310 Matt Hwy Ste 305
Cumming, GA 30028-8627
Phone
(561) 999-9650
NPI assigned
Nov 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Rachel Nittinger
Title
Director, Provider Credentialing
Phone
(561) 999-9650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5310 Matt Hwy Ste 305
Cumming, GA 30028-8627

Mailing address

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

Other names 1

  • Sage Dental of North Cumming 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

5310 Matt Hwy
Ste 304
Cumming, GA 30028

5310 Matt Hwy
Ste 305
Cumming, GA 30028
Phone (470) 533-1880

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1982369542",
    "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": "5310 MATT HWY STE 305",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300288627",
            "telephone_number": "561-999-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DENTAL GROUP OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "NITTINGER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR, PROVIDER CREDENTIALING",
        "authorized_official_telephone_number": "561-999-9650"
    },
    "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 North Cumming",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.