Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sage Dental of Jacksonville Southside PLLC

Organization Dentist · NPI 1710766001

Sage Dental of Jacksonville Southside PLLC is a Dentist in Jacksonville, Florida. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4540 Southside Blvd Ste 801
Jacksonville, FL 32216-5490
Phone: (561) 999-9650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1710766001
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cindy Roark — Svp & Chief Clinical Officer · (561) 999-9650
Other names Sage Dental Of Jacksonville Southside Pllc
NPI enumeratedSeptember 26, 2023
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023
Mailing addressPo Box 931622, Atlanta, GA 31193-1622

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