Pelican Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PELICAN PEDIATRIC DENTISTRY LLC

Practice address

260 Beth Stacey Blvd Unit 240
Lehigh Acres, FL 33936-6074

Phone

(925) 890-8492

NPI assigned

Jul 18, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Luther, DMDNPI 1710535349

Title

Manager

Phone

(925) 890-8492

Specialties & licenses 1

Addresses

Other names 1

• GROWING SMILES Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Nicholas Luther, DMD

  • Pediatric Dentistry
  • Trinity, FL
  • NPI 1710535349
  NPD Authorized official
• Matthew T Raso, DDS

  • Pediatric Dentistry
  • Lehigh Acres, FL
  • NPI 1992328884
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1265324644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 BETH STACEY BLVD UNIT 240",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 BETH STACEY BLVD UNIT 240",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366074",
            "telephone_number": "925-890-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "LUTHER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "925-890-8492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GROWING SMILES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Pedregal, M.ED
• Daylin De la Caridad Pedrero Gonzalez
• Pedro Ylisastigui. M.D.P.a.
• Liriam Maria Pelaez Menendez
• Pelican Haven,LLC
• Edel Raul Pena de la Cruz
• Thelma Lissette Pena Lozano
• Keyla De la Caridad Pena Perez I, RBT
• Lianis Pena Zamora
• Jennyfer Pena

• Pediatric Dentistry in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.