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DR. LOUIS JOHN THEODOROU JR. DMD, FAGD
NPI 1376614644
Dentist - General Practice in Glen Ridge, NJ

Active since November 10, 2006PECOS Enrolled
89 GLEN RIDGE AVE, GLEN RIDGE, NJ 07028(973) 743-6092 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Louis John Theodorou Jr. Dmd, Fagd NPPES

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

DR. LOUIS JOHN THEODOROU JR. DMD, FAGD (NPI 1376614644) is an individual general practice provider in Glen Ridge, New Jersey and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376614644
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. LOUIS JOHN THEODOROU JR.Credential: DMD, FAGD
Location Address89 GLEN RIDGE AVEGlen Ridge, NJ 07028-1413
Mailing Address89 Glen Ridge AveGlen Ridge, NJ 07028-1413 · (973) 743-6092
Phone(973) 743-6092
Sole ProprietorYes
Enumeration DateNovember 10, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1376614644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
89 GLEN RIDGE AVE, Glen Ridge, NJ 07028
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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. Louis John Theodorou Jr. Dmd, Fagd 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 07028 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
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.

GLEN RIDGE COSMETIC AND FAMILY DENTISTRY
Dentist
89 GLEN RIDGE AVE
GLEN RIDGE, NJ 07028
Essex County (973) 743-6092
DR. PAUL A CONDOURIS DMD
Dentist
89 GLEN RIDGE AVE
GLEN RIDGE, NJ 07028
Essex County (973) 743-6092

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 Louis Theodorou's NPI number?

The NPI number for Louis Theodorou is 1376614644. It was assigned to this individual provider in the NPPES registry on November 10, 2006.

Where is Louis Theodorou located?

Louis Theodorou practices at 89 Glen Ridge Ave, Glen Ridge, NJ 07028. The listed phone number is (973) 743-6092.

What is Louis Theodorou's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Louis Theodorou enrolled in Medicare?

Yes. Louis Theodorou is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Louis Theodorou was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.