Individual provider · Type 1 NPI

Kaitlyn Jane Matter, DMD

Student in an Organized Health Care Education/Training Program · Port Jefferson, NY

NPI number 1245174036 Active

Practice location

200 Belle Terre Rd
Port Jefferson, NY 11777-1968

Call (631) 474-6553 Map

Fax (631) 474-6332

Mailing address

6181 Tidewater Island Cir
Fort Myers, FL 33908-4681

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245174036

Kaitlyn Jane Matter, DMD's National Provider Identifier is 1245174036, issued on Apr 14, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Port Jefferson, NY. The record was last updated on Apr 14, 2026.