Marcela Matamoros, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN20300 Issued in FL

Practice address

19084 NE 29TH Ave
Aventura, FL 33180-2805

Phone

(786) 623-5898

NPI assigned

Apr 12, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1417311846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 SW BLUEBIRD CV",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19084 NE 29TH AVE",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802805",
            "telephone_number": "786-623-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAMOROS",
        "first_name": "MARCELA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN20300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvin Wellen, M.D.
• Mas Anesthesia Group LLC
• Anthony Masih, DPM
• Pedro Rafael Mastrodomenico Sanchez, MD
• Eric Silviano Matamoros
• David Mathai, M.D.
• Tony Balummel Matthews
• Mautner, DDS and Oppenheimer, DDS, PA
• Kevin Maxwell
• Dennis Mazal, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Aventura, FL
• Providers in Aventura, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.