Provider Demographics
NPI:1720573264
Name:SCOTT M. SAKOWITZ, D.M.D., M.S., P.A.
Entity Type:Organization
Organization Name:SCOTT M. SAKOWITZ, D.M.D., M.S., P.A.
Other - Org Name:SAKOWITZ SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:407-627-1187
Mailing Address - Street 1:9161 NARCOOSSEE RD STE 105B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-5764
Mailing Address - Country:US
Mailing Address - Phone:407-627-1187
Mailing Address - Fax:
Practice Address - Street 1:9161 NARCOOSSEE RD STE 105B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827
Practice Address - Country:US
Practice Address - Phone:407-627-1187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN231031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty