MEDICARE: SAGEVIEW DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1174482442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGEVIEW DENTAL PLLC

Provider Business Mailing Address
First Line	:	17803 LA CANTERA TER APT 6602
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2574
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1892 HIGHWAY 183
Second Line	:	STE 130
City	:	LEANDER
State	:	TX
Zip	:	78641-6570
Country	:	US
Telephone Number	:	703-201-2035
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	BASHIR MOTAMEDI
Credential	:
Telephone Number	:	703-201-2035

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “SAGEVIEW DENTAL PLLC ” Practice Location

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