Organization · Type 2 NPI

Ponte Vedra Orthodontics LLC

Orthodontics and Dentofacial Orthopedics Dentistry · Ponte Vedra Beach, FL

NPI number 1497560023 Active

Practice location

3109 Sawgrass Village Cir
Ponte Vedra Beach, FL 32082-5032

Fax (904) 871-8116

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	None listed

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1497560023

Ponte Vedra Orthodontics LLC's National Provider Identifier is 1497560023, issued on Feb 11, 2025. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Ponte Vedra Beach, FL. The record was last updated on Jun 16, 2026.