Individual provider Active NPI

Vanessa Matamoros Mena, DMD

  • Pediatric Dentistry
  • Vero Beach, FL
National Provider Identifier
1548893936
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN25067 Issued in FL
Practice address
1955 Pointe West Dr
Vero Beach, FL 32966-1302
Phone
(772) 567-5100
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN25067 FL Primary

Addresses

Primary practice location

1955 Pointe West Dr
Vero Beach, FL 32966-1302

Mailing address

14197 SW Pinnacle CT
Port St Lucie, FL 34987-6103
Phone (772) 528-3432

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

LicenseStateTypeSpecialty
DN25067FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicklaus Children'S Hospital Student in an Organized Health Care Education/Training Program PastSince Feb 2, 2025 Accepting new patients
Monika Srivastava DMD PA Plantation Pediatric Dentistry PastSince Jun 21, 2022 Accepting new patients
Spallone Family Dentistry & Associates PastSince Nov 18, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1548893936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14197 SW PINNACLE CT",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349876103",
            "telephone_number": "772-528-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 POINTE WEST DR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329661302",
            "telephone_number": "772-567-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "VANESSA",
        "middle_name": "MATAMOROS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN25067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.