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TIDEWATER LLC
NPI 1609366756
Dentist in Lanham, MD

Active since May 15, 2018
2830 CAMPUS WAY N STE 614, LANHAM, MD 20706(301) 955-9198(301) 955-9199 Get Directions Write a Review

NPPES record last updated: May 15, 2018. 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 1609366756) is a healthcare organization registered as a dentist in Lanham, Maryland and active in the NPI registry since May 2018. The organization lists David Cooper, Owner, as its authorized official.

NPPES Registry Identity

NPI1609366756
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameTIDEWATER LLC
Location Address2830 CAMPUS WAY N STE 614Lanham, MD 20706-1669
Mailing Address21534 Great Mills RdLexington Park, MD 20653-1204 · (301) 862-3900
Phone(301) 955-9198
Fax(301) 955-9199
Organization SubpartYes
Authorized OfficialDavid CooperOwner · (301) 862-3900
Enumeration DateMay 15, 2018
✔ NPI 1609366756 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.
2830 CAMPUS WAY N STE 614, Lanham, MD 20706
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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 4

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

DR. PHILLIP NGUYEN DDS
Dentist (Oral and Maxillofacial Surgery)
2830 CAMPUS WAY N STE 614
GLENARDEN, MD 20706
Prince George's County (301) 955-9198
DR. CHIKARA JAMILA SAUNDERS-FIDDERMON DDS
Dentist (Pediatric Dentistry)
2830 CAMPUS WAY N STE 614
LANHAM, MD 20706
Prince George's County (301) 955-9198
DR. GIBSON BARTELUS D.D.S.
Dentist (General Practice)
2830 CAMPUS WAY N STE 614
LANHAM, MD 20706
Prince George's County (301) 955-9198
ANGE LYDIE TCHOUAGA DDS
Dentist
2830 CAMPUS WAY N STE 614
GLENARDEN, MD 20706
Prince George's County (301) 563-9359

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 1609366756. It was assigned to this organization in the NPPES registry on May 15, 2018.

Where is Tidewater LLC located?

Tidewater LLC is located at 2830 Campus Way N Ste 614, Lanham, MD 20706. The listed phone number is (301) 955-9198.

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 May 15, 2018. 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.