DR. NICHOLAS THEODOTOU BDS, DDS
NPI 1174764039
Dentist - Oral and Maxillofacial Surgery in Pooler, GA

Q: What is Nicholas Theodotou's NPI number?

The NPI number for Nicholas Theodotou is 1174764039. It was assigned to this individual provider in the NPPES registry on March 23, 2009.

Q: What is Nicholas Theodotou's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since March 23, 2009PECOS Enrolled

506 US HIGHWAY 80 W, POOLER, GA 31322(912) 600-6060 Get Directions Write a Review

NPPES record last updated: August 9, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 9, 2021, May 25, 2021, May 6, 2021 and 1 more (4 updates tracked since 2017).

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About Dr. Nicholas Theodotou Bds, Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICHOLAS THEODOTOU BDS, DDS (NPI 1174764039) is an individual oral and maxillofacial surgery provider in Pooler, Georgia, licensed in Georgia (DN011530) and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174764039

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. NICHOLAS THEODOTOUCredential: BDS, DDS

Location Address506 US HIGHWAY 80 WPooler, GA 31322-2104

Mailing Address506 Us Highway 80 WPooler, GA 31322-2104 · (912) 600-6060

Phone(912) 600-6060

Sole ProprietorYes

Enumeration DateMarch 23, 2009

Last NPPES UpdateAugust 9, 20214 updates tracked since enumeration

NPPES CertifiedAugust 9, 2021

✔ NPI 1174764039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in GA · DN011530

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

506 US HIGHWAY 80 W, Pooler, GA 31322

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas Theodotou Bds, Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31322 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ORAL MAXILLOFACIAL SURGERY GROUP OF COASTAL GEORGIA

Dentist (Oral and Maxillofacial Surgery)

506 US HIGHWAY 80 W
POOLER, GA 31322

Chatham County (912) 600-6060

ORAL SURGERY GROUP OF COASTAL GEORGIA, LLC

Dentist (Oral and Maxillofacial Surgery)

506 US HIGHWAY 80 W
POOLER, GA 31322

Chatham County (912) 330-9229

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Theodotou's NPI number?

The NPI number for Nicholas Theodotou is 1174764039. It was assigned to this individual provider in the NPPES registry on March 23, 2009.

Where is Nicholas Theodotou located?

Nicholas Theodotou practices at 506 Us Highway 80 W, Pooler, GA 31322. The listed phone number is (912) 600-6060.

What is Nicholas Theodotou's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Nicholas Theodotou enrolled in Medicare?

Yes. Nicholas Theodotou is registered in the Medicare PECOS enrollment system.

What insurance does Nicholas Theodotou accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 11 other insurers list Nicholas Theodotou as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicholas Theodotou was last updated on August 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.