Joanna Theodorou, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN24617 Issued in FL

Practice address

15761 Sheridan St Ste a
Southwest Ranches, FL 33331-3486

Phone

(000) 000-0000

NPI assigned

Nov 14, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Darrin Cupo DMD PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Coral Springs, FL
  • NPI 1407076953
  NPD (past)
• Michael Maruri DMD PA

  • Dental Clinic/Center
  • Plantation, FL
  • NPI 1730481698
  NPD (past)

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698537600000",
    "number": "1346885274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15761 SHERIDAN ST STE A",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333313486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15761 SHERIDAN ST STE A",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333313486",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOROU",
        "first_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN24617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Stphard
• John Philip Stringham Jr.
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• Sun Coast Recovery Ranch LLC
• The Handicapped Compliancae Construction Co.
• Alicia Maria Toro, DDS
• Kimberley Valencia, RN, BSN
• Aracelis Vazquez Ortiz
• Miguel Venereo, MD
• Walgreen Co

• Pediatric Dentistry in Southwest Ranches, FL
• Providers in Southwest Ranches, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2023; 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.