Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Sage Dental of Avalon Park PLLC

Organization Dentist · NPI 1265194054

Sage Dental of Avalon Park PLLC provides Dentist services in Orlando, Florida. Registered with an NPI since 2021.

In the registry since
2021
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

12990 Tanja King Blvd
Orlando, FL 32828-7380
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 number1265194054
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cindy Roark — Svp, Chief Clinical Officer · (561) 999-9650
NPI enumeratedOctober 8, 2021
Last updated in NPPESMay 19, 2023
Certification dateMay 19, 2023
Mailing address6600 Congress Ave Ste 150, Boca Raton, FL 33487-1213

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