Theodore Petridis

Dentist · Brandon, FL

Individual Active NPI

NPI number 1124877139

Practice location

2468 W Brandon Blvd
Brandon, FL 33511-4717
Phone
(813) 257-9518

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NPI record

NPI
1124877139
Entity type
Individual (Type 1)
Enumeration date
May 14, 2024
Last updated
September 1, 2025
Certified
September 1, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DN29005 FL

Mailing address

9958 Jonas Salk Dr Apt 428
Riverview, FL 33578-7455

Other practice locations (1)

  • 13023 US Highway 301 S, Riverview, FL 33578-7439 · (813) 518-5542

About Theodore Petridis

Theodore Petridis is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 2468 W Brandon Blvd, Brandon, FL 33511-4717. The NPI number 1124877139 was assigned on May 14, 2024 and the record was last updated on September 1, 2025.

Theodore Petridis lists a license in the registry: #DN29005 (FL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Theodore Petridis?

The NPI number is 1124877139.

What is the phone number of Theodore Petridis?

The phone number listed for the practice location is (813) 257-9518.

Where is Theodore Petridis located?

2468 W Brandon Blvd, Brandon, FL 33511-4717.

What is the taxonomy code for Theodore Petridis?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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