Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater LLC

Organization Dentist · NPI 1609366756

Tidewater LLC is a Dentist in Lanham, Maryland. Licensed in Maryland. Registered with an NPI since 2018.

Licensed in
MD
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2830 Campus Way N Ste 614
Lanham, MD 20706-1669
Phone: (301) 955-9198
Fax: (301) 955-9199
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X (MD)

Record details

NPI number1609366756
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationTidewater LLC
Authorized official David Cooper — Owner · (301) 862-3900
NPI enumeratedMay 15, 2018
Last updated in NPPESMay 15, 2018
Mailing address21534 Great Mills Rd, Lexington Park, MD 20653-1204

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