THEODOROU PROFESSIONAL DENTAL CORP. (NPI# 1225152952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225152952 |
| Entity Type | Organization |
| Organization Name | THEODOROU PROFESSIONAL DENTAL CORP. |
| Other Organization Name | THEODROU PROFESSIONAL DENTAL GROUP |
| Practice Address |
19717 Sherman Way Canoga Park CA 91306 |
| Practice Telephone | 8187090090 |
| Practice Fax Number | 8187096002 |
| Mailing Telephone | 8187090090 |
| Mailing Fax Number | 8187096002 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | DR. NIKOLAOS THEODOROU (DENTIST PRESIDENT OF CORPORATION) |
| Authorized Official Telephone | 8187090090 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTICAL | G9133901 | 01 |
| Other Name | Type Code |
|---|---|
| Theodrou Professional Dental Group | Other Name - Individual/Organization |
| Street Address |
19717 SHERMAN WAY |
| City | CANOGA PARK |
| State | CA |
| Zip Code | 91306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255534293 | Larisa Theodorou | Dentist | 19717 Sherman Way, Canoga Park, CA 91306 | 2007-06-07 |
| 1245433283 | Nikolaos Theodorou | Dentist | 19717 Sherman Way, Canoga Park, CA 91306 | 2007-06-07 |
| 1710974837 | Victoria Dental Group - Theodorou Professional Dental Corp | Dentist | 19717 Sherman Way, Canoga Park, CA 91306-3601 | 2005-10-04 |
| 1659368835 | Victoria Dental Group - Theodorou Professional Dental Corp | Dentist | 19717 Sherman Way, Canoga Park, CA 91306-3601 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255856555 | California Physician Network LLC | Non-emergency Medical Transport (VAN) | 7657 Winnetka #712, Winnetka, CA 91306 | 2017-08-08 |
| 1073069373 | Mostafa Ahady | Optometrist | 7044 Oakdale Ave., Winnetka, CA 91306 | 2016-08-28 |
| 1922457340 | Evelin Garcia Psy.d. A Psychological Corporation | Community/Behavioral Health | 20832 Roscoe Blvd. Ste.202, Winnetka, CA 91306 | 2016-06-07 |
| 1104290485 | Edmond Reyhani | Pharmacist | 20839 W Roscoe Blvd, Winnetka, CA 91306 | 2015-11-24 |
| 1558730770 | Lester Antonio Marlin | Rehabilitation Practitioner | 20325 Sherman Way, Apt44, Winnetka, CA 91306 | 2015-09-17 |
| 1336578228 | Charmaine Fermin | Counselor | 20225 Cohasset St, Winnetka, CA 91306 | 2013-11-01 |
| 1669740429 | Robert Hazany | Dentist | 20832 Roscoe Blvd #101, Canoga Park, CA 91306 | 2011-12-08 |
| 1912223983 | Intrepid Anesthesia Associates Corporation | Anesthesiology | 427 W. Pueblo St., Santa Barbara, CA 91306 | 2010-04-15 |
| 1235315656 | Angelica Yerena | Marriage & Family Therapist | 20233 Lanark, Winnetka, CA 91306 | 2008-01-16 |
| 1205054434 | Winnetka Medical Group Inc | Family Medicine | 6742 Winnetka Ave, Winnetka, CA 91306 | 2007-04-23 |
| Find all providers in zip 91306 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033625181 | Seyyedhossein Mousavi | Dentist | 22030 Sherman Way Ste 219, Canoga Park, CA 91303-1855 | 2017-12-26 |
| 1114430824 | Western Dental Services, Inc. | Dentist | 21729 Vanowen St, Canoga Park, CA 91303-2618 | 2017-11-16 |
| 1649706128 | R. C. Abaro Dds Inc | Dentist | 7616 Topanga Canyon Blvd, Canoga Park, CA 91304-5534 | 2017-05-03 |
| 1093108599 | Ramya Chelimela | Dentist | 21126 Ingomar Ct, Canoga Park, CA 91304-5151 | 2015-03-09 |
| 1376982579 | Mojgan Sheikhavandi D.d.s.,inc. | Dentist | 7220 De Soto Ave, Canoga Park, CA 91303-1701 | 2013-06-20 |
| 1669740429 | Robert Hazany | Dentist | 20832 Roscoe Blvd #101, Canoga Park, CA 91306 | 2011-12-08 |
| 1780992099 | Shiv M. Shankar | Dentist | 7220 Vassar Ave, Canoga Park, CA 91303 | 2010-09-21 |
| 1992948780 | Patricia D Gordon | Dentist | 21001 Covello Street, Canoga Park, CA 91303 | 2009-04-09 |
| 1033374293 | Ziad G. Rhayem | Dentist | 21123 Victory Blvd, Canoga Park, CA 91303-2828 | 2008-07-26 |
| 1891973095 | Salina Sanchez Asidera | Dentist | 7214 Canoga Ave, Canoga Park, CA 91303-1627 | 2008-02-11 |
| Find all providers in CANOGA PARK | ||||
| City | CANOGA PARK |
| Zip Code | 91306 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.