Provider Demographics
NPI:1720599897
Name:LUGO, SABRINA STEWART (DDS)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:STEWART
Last Name:LUGO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:ALEXA
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1900 CRESTWOOD BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2056
Mailing Address - Country:US
Mailing Address - Phone:205-271-6841
Mailing Address - Fax:
Practice Address - Street 1:1180 PONCE DE LEON BLVD STE 401
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-1014
Practice Address - Country:US
Practice Address - Phone:727-261-0304
Practice Address - Fax:205-271-6836
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN285881223P0221X
AL6469122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist