Tidewater Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TIDEWATER DENTAL LLC

Practice address

10104 Ford Ave Ste G2
Richmond Hill, GA 31324-8850

Phone

(207) 991-1064

NPI assigned

Sep 28, 2026

Last updated

Sep 28, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Parent, DMDNPI 1215594387

Title

Dentist

Phone

(207) 991-1064

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher David Parent, DMD

  • General Practice Dentistry
  • Porter, ME
  • NPI 1215594387
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1033022272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 KERRY DR",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313249210",
            "telephone_number": "207-991-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10104 FORD AVE STE G2",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248850",
            "telephone_number": "207-991-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "PARENT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "207-991-1064",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Urgent Care Center of Richmond Hill, LLC (ExperCARE)
• Beverley V Theodore, LPC
• Donald E Thomas
• Kanazeya Thomas
• Leigh Sotos Thompson, M.D.
• Michael Tillery, R.N.
• Kaylee Denise Andsager Tilley, LCMFT
• Melanie Hicks Tillman, M.A., CCC-SLP
• Savanna L Tinsley
• Gurkaran Toor

• General Practice Dentistry in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.