Tidewater Dental Center, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401411261 Issued in VA

Legal business name

TIDEWATER DENTAL CENTER, PLLC

Practice address

425 W 20TH St
3
Norfolk, VA 23517-2128

Phone

(757) 622-4245

Fax

(757) 622-3722

NPI assigned

Aug 13, 2008

Last updated

Aug 13, 2008By 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

Ms. Amy D Ford

Title

Vice President of Operations

Phone

(757) 622-4245

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Ethel Marlene Miles, D.D.S.

  • General Practice Dentistry
  • Norfolk, VA
  • NPI 1962605675
  NPD (past)
• Natalie Caspers Nguyen, DDS

  • Dentist
  • Matthews, NC
  • NPI 1831349158
  NPD (past)

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1275789950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W 20TH ST",
            "address_2": "3",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172128",
            "telephone_number": "757-622-4245",
            "fax_number": "757-622-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 20TH ST",
            "address_2": "3",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172128",
            "telephone_number": "757-622-4245",
            "fax_number": "757-622-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER DENTAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "757-622-4245",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith A. Tice
• Tidal Counseling, PLC
• Tidemed Inc (TideCare Home Health Services)
• Tidepool Integrative Psychotherapy LLC
• Tidewater Comprehensive Rehabilitation, PLLC
• Tidewater Dermatopathology Service, Inc
• Tidewater Diagnostic Consultants, LLC (Tidewater Mobile Phlebotomy Service)
• Tidewater Home Care, Inc.
• Tidewater Hyperbaric
• Tidewater Kidney Specialists, Inc. (Tidewater Vascular Access Center)

• General Practice Dentistry in Norfolk, VA
• Providers in Norfolk, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.