Tide Dental Corpus Christi PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

TIDE DENTAL CORPUS CHRISTI PLLC

Practice address

1312 Airline Road
Corpus Christi, TX 78412

Phone

(361) 994-4867

Fax

(361) 994-1655

NPI assigned

Nov 28, 2011

Organization subpart

No

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

Authorized official

Name

Faith Gaskins

Title

Director of Credentialing

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Tide Dental Doing business as

Locations

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1720355381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734753",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753734753",
            "telephone_number": "972-869-3789",
            "fax_number": "972-590-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 AIRLINE ROAD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78412",
            "telephone_number": "361-994-4867",
            "fax_number": "361-994-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDE DENTAL CORPUS CHRISTI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tide Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Travis Thompson, M.D.
• Terrance Heath Thornburg, TECHNICIAN
• Brooke L Thorpe, PT
• Lara Camille Thurmond, APRN-CNP
• Brent Tibbet, DMD, MS
• Maria Tiefenbach, DMD
• John Tijerina
• Nakita Nicole Tijerina, LVN
• Florence Garcia Tiller, SLP
• Franca Mngu Tilley-Gyado, M.D

• Dentist in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.