Steven P. Theodosis Dental Corporation
Clinic/Center, Dental in San Diego, CA. Organization (NPI-2).
NPI number1760102628
StatusActive
Last updated in NPPESFeb 13, 2026
Details
- NPI
- 1760102628
- Entity type
- Organization (NPI-2)
- Legal business name
- Steven P. Theodosis Dental Corporation
- Organization subpart
- No
- Enumeration date
- Aug 31, 2022
- Certification date
- Feb 13, 2026
- Last updated
- Feb 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
7805 Highland Village Pl Ste G105San Diego, CA 92129-5181
Phone 650-922-0897
Mailing address
23911 Danzig BayDana Point, CA 92629-4407
Authorized official
Steven Paul Theodosis
Authorized Official
8477781423
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