Amanda Jones Theodorson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN10001016 Issued in DC

Practice address

3020 14TH St NW
Washington, DC 20009-6865

Phone

(202) 745-4300

NPI assigned

Oct 5, 2009

Sex

Female

Sole proprietor

No

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

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.theodorson@uhci.eclinicaldirectplus.com

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.

• Unity Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1093894172
  Medicare reassignment NPD
• Unity Health Care Inc.

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1346014412
  NPD

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662854400000",
    "number": "1962737239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 14TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 14TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096865",
            "telephone_number": "202-745-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORSON",
        "first_name": "AMANDA",
        "middle_name": "JONES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2022-09-11",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN10001016",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Theis, LGSW
• Renee Theisen, FNP
• Nicholas Scott Thelen, MD
• Kelly Allison Thelin, PA-C
• Kathleen Theodore, MPT
• Alexander Ian Theodotou
• Pwe Che N/a Theophile
• Margaret Nkwimi-Moliki Theophilus
• Therapeutic Links Behavioral Health Services, LLC
• Therapeutic Sessions Corporation

• Dentist in Washington, DC
• Providers in Washington, DC by specialty
• Dentist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.