Sage Dental of Brandon PLLC
NPI 1417617689ActiveOrganization· Dentist· Brandon, FL
Dentist in Brandon, Florida, registered in NPPES in December 2021. The authorized official on file is Cindy Roark, DMD, MS, Svp & Chief Clinical Officer.
Overview
| NPI | 1417617689 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 29, 2021 |
| Last updated in NPPES | May 19, 2023 |
| Certified by provider | May 19, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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