Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124877139 Individual Practitioner Male Practitioner

Theodore Petridis

Dentist • Brandon, FL

Professional Overview & Biography Verified Profile Summary

Theodore Petridis is a registered healthcare professional specializing in Dentist in Brandon, FL. Practice services are available at 2468 W BRANDON BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2468 W Brandon Blvd

Brandon, FL 335114717

Telephone 8132579518

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Brandon, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.2 Yrs
Regional Practice Density
48 Specialists

Practicing in Brandon, FL (6414 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-01
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License FL DN29005

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.

Secondary Practice Locations

13023 Us Highway 301 S

Riverview, FL 335787439

Phone: 8135185542

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Matthew Nieber , DDS

Dentist - General Practice

NPI 1063593291

Doctor of Dental Surgery

NPI 1891828471

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location September 01, 2025

Registered at 2468 W BRANDON BLVD, BRANDON, FL 335114717 (Tel: 8132579518)

📍
Updated Business Mailing Address June 10, 2024

Registered at 9958 JONAS SALK DR APT 428, RIVERVIEW, FL 335787455

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2024

Dentist (License #DN29005 in FL)

NPI Profile Active May 14, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location May 14, 2024

Registered at 13023 US HIGHWAY 301 S, RIVERVIEW, FL 335787439 (Tel: 8135185542)

📍
Updated Business Mailing Address May 14, 2024

Registered at 19W276 PALACE GREEN LN, OAK BROOK, IL 605231038

👤
Provider Name / Credentials Updated May 14, 2024

Recorded as THEODORE PETRIDIS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 14, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124877139
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 14, 2024
Last Update: September 01, 2025
Sole Proprietor: Yes

Mailing Address

9958 Jonas Salk Dr Apt 428

Riverview, FL 335787455

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.