Healthcare Provider Details

I. General information

NPI: 1083531198
Provider Name (Legal Business Name): SAGE DENTAL OF DUNEDIN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 MAIN ST
DUNEDIN FL
34698-6242
US

IV. Provider business mailing address

6600 CONGRESS AVE STE 150
BOCA RATON FL
33487-1213
US

V. Phone/Fax

Practice location:
  • Phone: 561-999-9650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: CINDY ROARK
Title or Position: SVP & CHIEF CLINICAL OFFICER
Credential: DMD, MS
Phone: 561-999-9650