TIDEWATER DENTAL PF
NPI 1053607002
Dentist in Prince Frederick, MD

Q: What is Tidewater Dental Pf's NPI number?

The NPI number for Tidewater Dental Pf is 1053607002. It was assigned to this organization in the NPPES registry on June 28, 2011.

Q: What is Tidewater Dental Pf's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since June 28, 2011

690 PRINCE FREDERICK BLVD, PRINCE FREDERICK, MD 20678(410) 414-8333(301) 862-3779 Get Directions Write a Review

NPPES record last updated: June 28, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tidewater Dental Pf NPPES

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

TIDEWATER DENTAL PF (NPI 1053607002) is a healthcare organization registered as a dentist in Prince Frederick, Maryland and active in the NPI registry since June 2011. The organization lists Connie M Mccabe, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1053607002

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameTIDEWATER DENTAL PF

Location Address690 PRINCE FREDERICK BLVDPrince Frederick, MD 20678

Mailing Address690 Prince Frederick BlvdPrince Frederick, MD 20678 · (410) 414-8333 · Fax (301) 862-3779

Phone(410) 414-8333

Fax(301) 862-3779

Organization SubpartNo

Authorized OfficialConnie M MccabeOffice Manager · (301) 862-3900

Enumeration DateJune 28, 2011

✔ NPI 1053607002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in MD · 6466✔ Licensed in MD · 14501

Definition

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.

690 PRINCE FREDERICK BLVD, Prince Frederick, MD 20678

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

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.

JIM LEE, LLC

Dentist (Orthodontics and Dentofacial Orthopedics)

690 PRINCE FREDERICK BLVD
PRINCE FREDERICK, MD 20678

Calvert County (202) 423-8867

CHESAPEAKE ORTHODONTICS, LLC

Dentist (Orthodontics and Dentofacial Orthopedics)

690 PRINCE FREDERICK BLVD
PRINCE FREDERICK, MD 20678

Calvert County (443) 968-8133

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 Tidewater Dental Pf's NPI number?

The NPI number for Tidewater Dental Pf is 1053607002. It was assigned to this organization in the NPPES registry on June 28, 2011.

Where is Tidewater Dental Pf located?

Tidewater Dental Pf is located at 690 Prince Frederick Blvd, Prince Frederick, MD 20678. The listed phone number is (410) 414-8333.

What is Tidewater Dental Pf's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Tidewater Dental Pf was last updated on June 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.