Active NPI
Matthew T Raso, DDS
- Pediatric Dentistry
- Lehigh Acres, FL
National Provider Identifier
1992328884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN25812
- Practice address
- 260 Beth Stacey Blvd Unit 240
Lehigh Acres, FL 33936-6074 - Phone
- (239) 491-6977
- NPI assigned
- May 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN25812 | FL | Primary |
Addresses
Primary practice location
260 Beth Stacey Blvd Unit 240
Lehigh Acres, FL 33936-6074
Mailing address
3631 Blue Fin Way Unit 104
Fort Myers, FL 33916-8447
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 |
|---|---|---|---|
| DN25812 | FL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelican Pediatric Dentistry LLC | Pediatric Dentistry | Current | Accepting new patients |
Locations
260 Beth Stacey Blvd
Unit 240
Lehigh Acres, FL 33936
Phone (239) 369-0700
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Lehigh Acres, FL
- NPI 1265324644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755734400000",
"number": "1992328884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3631 BLUE FIN WAY UNIT 104",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339168447"
},
{
"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": "239-491-6977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASO",
"first_name": "MATTHEW",
"middle_name": "T",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-26",
"last_updated": "2025-08-21",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN25812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lehigh Acres, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.