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

Tidewater Medspa PLLC

Organization Health Service Clinic/Center · NPI 1356099113

Tidewater Medspa PLLC is a Health Service Clinic/Center in Portsmouth, Virginia. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3400 Airline Blvd
Portsmouth, VA 23701-2623
Phone: (757) 470-9454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X

Record details

NPI number1356099113
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Margot Wilson — Owner · (757) 470-9454
NPI enumeratedMarch 11, 2022
Last updated in NPPESMarch 11, 2022
Certification dateMarch 10, 2022
Mailing address3400 Airline Blvd, Portsmouth, VA 23701-2623

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