Theodore Edward David Peters, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN0013473 Issued in FL

Practice address

508 South Habana Ave
Suite 110
Tampa, FL 33609

Phone

(813) 870-1220

Fax

(813) 870-2615

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 16, 2013 through May 16, 2027

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.

• Theodore Edward David Peters, DDS,PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Tampa, FL
  • NPI 1255501342
  NPD (past) Authorized official

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457342750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 SOUTH HABANA AVE",
            "address_2": "SUITE 110",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-870-1220",
            "fax_number": "813-870-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 SOUTH HABANA AVE",
            "address_2": "SUITE 110",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-870-1220",
            "fax_number": "813-870-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "THEODORE",
        "middle_name": "EDWARD DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0013473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Christopher Peters, PA-C
• Christina Diane Peters, PH.D.
• Gerard Philip Peters, R.PH.
• Greer Greer Peters, LMHC
• Pamela Peters
• Victoria Peters
• Leah Gail Petersen, PA-C
• Victoria Petersen
• Jared B Petersmith, CRNA
• Alexis Peterson

• Dentist in Tampa, FL
• Providers in Tampa, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.