Tidewater LLC
NPI 1306359054ActiveOrganization· Dentist· Prince Frederick, MD
Dentist in Prince Frederick, Maryland, registered in NPPES in November 2017, part of Tidewater LLC. The authorized official on file is David Cooper, DDS, Owner.
Overview
| NPI | 1306359054 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Tidewater LLC |
| NPI issued | Nov 15, 2017 |
| Last updated in NPPES | Nov 15, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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