Dimitrios Theodoridis, M.D.

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

0101044634 Issued in VA

Practice address

26317 W. Washington Street
Petersburg, VA 23803-0030

Phone

(804) 524-7005

Fax

(804) 524-4807

NPI assigned

Mar 2, 2006

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851368401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 QUEEN SCOT DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232355545",
            "telephone_number": "804-276-2441",
            "fax_number": "804-524-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26317 W. WASHINGTON STREET",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238030030",
            "telephone_number": "804-524-7005",
            "fax_number": "804-524-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORIDIS",
        "first_name": "DIMITRIOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "VA",
            "license": "0101044634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Empowerment Lab LLC
• The Learning and Integrating New Knowledge and Skills Center, Inc. (T
• The Olivia Taylor House, LLC
• The Outreach Foundation, LLC
• The Petersburg Smile Center, P.C.
• Therapeutic in Home Counseling
• Harindran Theruvath, M.D.
• Thisability Community Engagement
• Chiquita Michone Thomas-Jackson, NP
• Michael Anthony Thomas, LPC

• Forensic Psychiatry Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Forensic Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.