Annette Constance Theofilos, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.020094 Issued in OH

Practice address

255 Charleston Rd
Sharpsville, PA 16150-3303

Phone

(724) 962-0403

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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.

• Actdental,Inc

  • General Practice Dentistry
  • Hermitage, PA
  • NPI 1366115131
  NPD Authorized official

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1528083938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 SHENANGO VALLEY FWY",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161482544",
            "telephone_number": "724-346-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CHARLESTON RD",
            "city": "SHARPSVILLE",
            "state": "PA",
            "postal_code": "161503303",
            "telephone_number": "724-962-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOFILOS",
        "first_name": "ANNETTE",
        "middle_name": "CONSTANCE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS028955L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.020094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Puskar Chiropractic, PLLC
• Jacob Allen Puskar, DC
• Jason William Schlieper, RPH, BCPS
• Sharpsville Area School District
• Trevor Michael Skinner, DDS
• Thrift Drug Inc (Rite Aid Pharmacy 10996)
• Neva Turner
• Upmc Community Medicine, Inc. (Horizon Family Medicine - UPMC - Sharpsville)
• Valley Medical Center, Inc
• Vincent a Ciambotti DO Inc

• Dentist in Sharpsville, PA
• Providers in Sharpsville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.