1. Home
  2. Directory
  3. Maryland
  4. Lexington Park
  5. Dentist
  6. NPI Profile

TIDEWATER DENTAL AND ASSOC INC
NPI 1184703803
Dentist - General Practice in Lexington Park, MD

Active since November 03, 2006
21534 GREAT MILLS RD, LEXINGTON PARK, MD 20653(301) 862-3900(301) 862-3779 Get Directions Write a Review

NPPES record last updated: July 1, 2008. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Tidewater Dental And Assoc Inc NPPES

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

TIDEWATER DENTAL AND ASSOC INC (NPI 1184703803), doing business as David J Cooper Michael W Owens Hae Sook Kim, is a healthcare organization registered as a general practice in Lexington Park, Maryland and active in the NPI registry since November 2006. The organization lists Connie M Mccabe, Financial Admin, as its authorized official.

NPPES Registry Identity

NPI1184703803
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameTIDEWATER DENTAL AND ASSOC INC
Location Address21534 GREAT MILLS RDLexington Park, MD 20653
Mailing Address21534 Great Mills RdLexington Park, MD 20653 · (301) 862-3900 · Fax (301) 862-3779
Phone(301) 862-3900
Fax(301) 862-3779
Organization SubpartNo
Authorized OfficialConnie M MccabeFinancial Admin · (301) 862-3900
Enumeration DateNovember 3, 2006
Last NPPES UpdateJuly 1, 2008
✔ NPI 1184703803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in MD · MD6466✔ Licensed in MD · MD13051✔ Licensed in MD · MD13931
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.
21534 GREAT MILLS RD, Lexington Park, MD 20653
Open in Google Maps ↗

Other Names 1

Former Legal Business NameDavid J Cooper Michael W Owens Hae Sook Kim

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 7

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

TIDEWATER LLC
Dentist
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-3900
DR. JACOB NATHAN KOTT DDS
Dentist (General Practice)
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-3900
DR. TODD DANIEL COOPER D.D.S.
Dentist
21534 GREAT MILLS RD
LEXINGTON PK, MD 20653
St. Mary's County (301) 862-3900
DR. JOHN PHILIP SEISMAN JR. DDS
Dentist (General Practice)
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-3900
TIDEWATER LLC
Dentist
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-3900
TIDEWATER DENTAL SLEEP THERAPY LLC
Dentist
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-3900
DR. DAVID JACK COOPER DDS
Dentist
21534 GREAT MILLS RD
LEXINGTON PK, MD 20653
St. Mary's County (301) 862-3900

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 And Assoc Inc's NPI number?

The NPI number for Tidewater Dental And Assoc Inc is 1184703803. It was assigned to this organization in the NPPES registry on November 3, 2006. The provider was formerly known as David J Cooper Michael W Owens Hae Sook Kim.

Where is Tidewater Dental And Assoc Inc located?

Tidewater Dental And Assoc Inc is located at 21534 Great Mills Rd, Lexington Park, MD 20653. The listed phone number is (301) 862-3900.

What is Tidewater Dental And Assoc Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Tidewater Dental And Assoc Inc was last updated on July 1, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.