1. Home
  2. Directory
  3. Maryland
  4. Prince Frederick
  5. Dentist
  6. NPI Profile

TIDEWATER LLC
NPI 1306359054
Dentist in Prince Frederick, MD

Active since November 15, 2017
700 PRINCE FREDERICK BLVD, PRINCE FREDERICK, MD 20678(410) 414-8333(240) 652-8797 Get Directions Write a Review

NPPES record last updated: November 15, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tidewater Llc NPPES

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

TIDEWATER LLC (NPI 1306359054) is a healthcare organization registered as a dentist in Prince Frederick, Maryland and active in the NPI registry since November 2017. The organization lists David Cooper, Owner, as its authorized official.

NPPES Registry Identity

NPI1306359054
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameTIDEWATER LLC
Location Address700 PRINCE FREDERICK BLVDPrince Frederick, MD 20678-3141
Mailing Address21534 Great Mills RdLexington Park, MD 20653-1204 · (301) 862-3900 · Fax (301) 862-3779
Phone(410) 414-8333
Fax(240) 652-8797
Organization SubpartYes
Authorized OfficialDavid CooperOwner · (301) 862-3900
Enumeration DateNovember 15, 2017
✔ NPI 1306359054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
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.
700 PRINCE FREDERICK BLVD, Prince Frederick, MD 20678
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

DR. REZA NIKPOURFARD D.D.S.
Dentist (General Practice)
700 PRINCE FREDERICK BLVD
PRINCE FREDERICK, MD 20678
Calvert County (410) 414-8333

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 LLC's NPI number?

The NPI number for Tidewater LLC is 1306359054. It was assigned to this organization in the NPPES registry on November 15, 2017.

Where is Tidewater LLC located?

Tidewater LLC is located at 700 Prince Frederick Blvd, Prince Frederick, MD 20678. The listed phone number is (410) 414-8333.

What is Tidewater LLC'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 LLC was last updated on November 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.