OrganizationActive
Orthodontic Professional Services
NPI 1669977203 · Orthodontics and Dentofacial Orthopedics Dentistry · Port St Lucie, FL
Provider details
- NPI number
- 1669977203
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Marcela Matamoros, President(772) 528-3434
- License
- DN20300 (FL)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1813 Se Port St Lucie Blvd
Port St Lucie, FL 34952-5544
Phone: (772) 528-3434
Street-level locationGet directions
Mailing address
1813 Se Port St Lucie Blvd
Port St Lucie, FL 34952-5544
Other names (DBA / former)
- Doing business as
- Ion Orthodontics
Registry dates
- Enumerated
- 2018-03-26
- Last updated
- 2018-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.