Active NPI
John S Theodorou, DDS
- Dentist
- Sunny Isles Beach, FL
National Provider Identifier
1962789701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN3019
- Practice address
- 19380 Collins Ave
Unit 1122-B
Sunny Isles Beach, FL 33160-2239 - Phone
- (305) 801-7537
- NPI assigned
- Nov 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN3019 | FL | Primary |
Addresses
Primary practice location
19380 Collins Ave
Unit 1122-B
Sunny Isles Beach, FL 33160-2239
Mailing address
19380 Collins Ave
Unit 1122-B
Sunny Isles Beach, FL 33160-2239
Phone (305) 801-7537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN3019 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1962789701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19380 COLLINS AVE",
"address_2": "UNIT 1122-B",
"city": "SUNNY ISLES BEACH",
"state": "FL",
"postal_code": "331602239",
"telephone_number": "305-801-7537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19380 COLLINS AVE",
"address_2": "UNIT 1122-B",
"city": "SUNNY ISLES BEACH",
"state": "FL",
"postal_code": "331602239",
"telephone_number": "305-801-7537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEODOROU",
"first_name": "JOHN",
"middle_name": "S",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-08",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN3019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunny Isles Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.