Anastasia Theodorou, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3712 Issued in ME

Practice address

19111 Detroit Rd Ste 204
Rocky River, OH 44116-1740

Phone

(440) 356-1000

Fax

(440) 356-2090

NPI assigned

Sep 3, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Beachcliff Dental Associates of Rocky River

  • General Practice Dentistry
  • Rocky River, OH
  • NPI 1760774343
  NPD (past) Authorized official
• Beachcliff Dental Associates of Rocky River - a Theodorou DMD LLC

  • General Practice Dentistry
  • Rocky River, OH
  • NPI 1538772405
  NPD
• North Hills Dental LLC

  • General Practice Dentistry
  • Meridian, MS
  • NPI 1720691892
  NPD

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1407958960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 DETROIT RD STE 206",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161740",
            "telephone_number": "207-784-4222",
            "fax_number": "207-784-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19111 DETROIT RD STE 204",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161740",
            "telephone_number": "440-356-1000",
            "fax_number": "440-356-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOROU",
        "first_name": "ANASTASIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0402338",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tender Loving Care in Home Care, LLC
• The Cleveland Clinic Foundation
• The Cleveland Clinic Foundation
• The Cleveland Clinic Foundation
• The Epic Group, Inc Dba Senior Concierge Services
• Therapeutic Resources Inc.
• Thoma & Sutton Eyecare Professionals, LLC
• Rashida Thomas
• Ryan Caleb Thomason, LSW
• Todd J Esterburg, Lisw, LLC

• General Practice Dentistry in Rocky River, OH
• Providers in Rocky River, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.