Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. PETER THEOHARIDIS D.M.D.
NPI 1831176494
Dentist - Oral and Maxillofacial Pathology in South Yarmouth, MA

Active since December 26, 2005PECOS Enrolled
241 STATION AVE, SOUTH YARMOUTH, MA 02664(508) 398-6055(508) 398-7228 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Peter Theoharidis D.m.d. NPPES

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

DR. PETER THEOHARIDIS D.M.D. (NPI 1831176494) is an individual oral and maxillofacial pathology provider in South Yarmouth, Massachusetts, licensed in Massachusetts (17344) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Tufts University School Of Medicine (1990).

NPPES Registry Identity

NPI1831176494
Entity TypeIndividualMale
Primary Taxonomy1223P0106X
Provider Legal NameDR. PETER THEOHARIDISCredential: D.M.D.
Location Address241 STATION AVESouth Yarmouth, MA 02664-1863
Mailing Address241 Station AveSouth Yarmouth, MA 02664-1863 · (508) 398-6055 · Fax (508) 398-7228
Fax(508) 398-7228
Sole ProprietorNo
Medical School CMSTufts University School Of MedicineGraduated 1990
Enumeration DateDecember 26, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1831176494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers
Taxonomy Code1223P0106X
License Licensed in MA · 17344
Definition

The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.

241 STATION AVE, South Yarmouth, MA 02664

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Peter Theoharidis D.m.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173611100
PECOS Enrollment IDI20071108000516
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 02664 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
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.

Dentist (Oral and Maxillofacial Surgery)
241 STATION AVE
SOUTH YARMOUTH, MA 02664
Dentist (Oral and Maxillofacial Pathology)
241 STATION AVE
SOUTH YARMOUTH, MA 02664

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831176494, enumerated as an "individual" on December 26, 2005.

The provider is located at 241 STATION AVE SOUTH YARMOUTH, MA 02664 and the phone number is (508) 398-6055.

Dentist with taxonomy code 1223P0106X and a focus in Oral and Maxillofacial Pathology.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, Anthem Blue. Please consult your insurance carrier or call the provider to verify.