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TIDELANDS DENTAL ON GLENNS BAY LLC
NPI 1619507019
Dentist - General Practice in Surfside Beach, SC

Active since January 24, 2020
1625 GLENNS BAY RD, SURFSIDE BEACH, SC 29575(843) 650-4500(843) 650-4510 Get Directions Write a Review

NPPES record last updated: January 24, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tidelands Dental On Glenns Bay Llc NPPES

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

TIDELANDS DENTAL ON GLENNS BAY LLC (NPI 1619507019) is a healthcare organization registered as a general practice in Surfside Beach, South Carolina and active in the NPI registry since January 2020. The organization lists Peter Jones, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1619507019
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameTIDELANDS DENTAL ON GLENNS BAY LLC
Location Address1625 GLENNS BAY RDSurfside Beach, SC 29575-4836
Mailing Address3577 Marion LnMurrells Inlet, SC 29576-6012 · (603) 531-1001
Phone(843) 650-4500
Fax(843) 650-4510
Organization SubpartNo
Authorized OfficialPeter JonesBusiness Manager · (603) 531-1001
Enumeration DateJanuary 24, 2020
✔ NPI 1619507019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.

1625 GLENNS BAY RD, Surfside Beach, SC 29575
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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 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.

J.HAROLD CAPPS,JR., DMD,PC DBAGLENNS BAY DENTAL ASSOCIATES
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-5100
EDWARD H GOLDBERG IV
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-5100
DR. JULIE OBENCHAIN
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-5100
JOSEPH HAROLD CAPPS JR.
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-5100
RAYMOND E CLEARY III DDS
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-5100
GLENNS BAY DENTAL ASSOCIATES LLC
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-5100
DRS CLONINGER AND REIMELS LLC
Dentist (General Practice)
1625 GLENNS BAY RD
SURFSIDE BEACH, SC 29575
Horry County (843) 650-4500

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 Tidelands Dental On Glenns Bay LLC's NPI number?

The NPI number for Tidelands Dental On Glenns Bay LLC is 1619507019. It was assigned to this organization in the NPPES registry on January 24, 2020.

Where is Tidelands Dental On Glenns Bay LLC located?

Tidelands Dental On Glenns Bay LLC is located at 1625 Glenns Bay Rd, Surfside Beach, SC 29575. The listed phone number is (843) 650-4500.

What is Tidelands Dental On Glenns Bay LLC'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 Tidelands Dental On Glenns Bay LLC was last updated on January 24, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.