NPIMap

Organization Active NPI

Beachcliff Dental Associates of Rocky River

  • General Practice Dentistry
  • Rocky River, OH
National Provider Identifier
1760774343
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30022463 Issued in OH
Legal business name
BEACHCLIFF DENTAL ASSOCIATES OF ROCKY RIVER
Practice address
19111 Detroit Rd
Suite 204
Rocky River, OH 44116-1786
Phone
(440) 356-1000
NPI assigned
May 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Authorized official

Name
Dr. Anastasia Theodorou, DDSNPI 1407958960
Title
Dentist
Phone
(440) 250-8775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30022463 OH Primary

Addresses

Primary practice location

19111 Detroit Rd
Suite 204
Rocky River, OH 44116-1786

Mailing address

19111 Detroit Rd
Suite 204
Rocky River, OH 44116-1786
Phone (440) 356-1000

Other names 1

  • Anastasia Theodorou DDS LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

19111 Detroit Rd
Ste 204
Rocky River, OH 44116
Phone (440) 356-1000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305244800000",
    "number": "1760774343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 DETROIT RD",
            "address_2": "SUITE 204",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161786",
            "telephone_number": "440-356-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19111 DETROIT RD",
            "address_2": "SUITE 204",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161786",
            "telephone_number": "440-356-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHCLIFF DENTAL ASSOCIATES OF ROCKY RIVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A",
        "authorized_official_last_name": "THEODOROU",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "440-250-8775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anastasia Theodorou DDS LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.