Tidelands Dental on Glenns Bay LLC
NPI 1619507019ActiveOrganization· Dentist, General Practice· Surfside Beach, SC
Dentist, General Practice in Surfside Beach, South Carolina, registered in NPPES in January 2020. The authorized official on file is Peter Jones, Business Manager.
Overview
| NPI | 1619507019 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 24, 2020 |
| Last updated in NPPES | Jan 24, 2020 |
| Certified by provider | Jan 24, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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