NPIMap

Organization Active NPI

Tidal Smiles Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Chesapeake, VA
National Provider Identifier
1548782873
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
TIDAL SMILES PEDIATRIC DENTISTRY PLLC
Practice address
350 Johnstown Rd Ste C
Chesapeake, VA 23322-5365
Phone
(757) 482-4777
NPI assigned
Jul 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Daniel Luke Winter, DDSNPI 1629481882
Title
Pediatric Dentist, Owner
Phone
(757) 482-4777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

350 Johnstown Rd Ste C
Chesapeake, VA 23322-5365

Mailing address

350 Johnstown Rd Ste C
Chesapeake, VA 23322-5365
Phone (757) 482-4777

National Provider Directory

National Provider Directory
Tax ID family
Tidal Smiles Pediatric Dentistry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1548782873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 JOHNSTOWN RD STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225365",
            "telephone_number": "757-482-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 JOHNSTOWN RD STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225365",
            "telephone_number": "757-482-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDAL SMILES PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WINTER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "LUKE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST, OWNER",
        "authorized_official_telephone_number": "757-482-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.