Active NPI
Martine Ann Decambre, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Port St. Lucie, FL
National Provider Identifier
1104968163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN15895
- Practice address
- 1620 SW Bayshore Blvd
Port St. Lucie, FL 34984 - Phone
- (772) 344-7771
- Fax
- (772) 878-9589
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN15895 | FL | Primary |
Addresses
Primary practice location
1620 SW Bayshore Blvd
Port St. Lucie, FL 34984
Mailing address
1620 SW Bayshore Blvd
Port St. Lucie, FL 34984
Phone (772) 344-7771
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN15895 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104968163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 SW BAYSHORE BLVD",
"city": "PORT ST. LUCIE",
"state": "FL",
"postal_code": "34984",
"telephone_number": "772-344-7771",
"fax_number": "772-878-9589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 SW BAYSHORE BLVD",
"city": "PORT ST. LUCIE",
"state": "FL",
"postal_code": "34984",
"telephone_number": "772-344-7771",
"fax_number": "772-878-9589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECAMBRE",
"first_name": "MARTINE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN15895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St. Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.