OrganizationActive
Tidewater Dental Pf
NPI 1053607002 · Dentist · Prince Frederick, MD
Tidewater Dental Pf is a Dentist organization in Prince Frederick, MD (NPI 1053607002).
Provider details
- NPI number
- 1053607002
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Connie Mccabe, Office Manager(301) 862-3900
- License
- 14501 (MD)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
690 Prince Frederick Blvd
Prince Frederick, MD 20678
Phone: (410) 414-8333
Fax: (301) 862-3779
Street-level locationGet directions
Mailing address
690 Prince Frederick Blvd
Prince Frederick, MD 20678
Registry dates
- Enumerated
- 2011-06-28
- Last updated
- 2011-06-28
Frequently asked questions
- What is Tidewater Dental Pf's NPI number?
- Tidewater Dental Pf's National Provider Identifier (NPI) is 1053607002, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Tidewater Dental Pf?
- Tidewater Dental Pf is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Tidewater Dental Pf located?
- Tidewater Dental Pf's practice location on file with NPPES is 690 Prince Frederick Blvd, Prince Frederick, MD 20678.
- What is Tidewater Dental Pf's phone number?
- The practice phone number listed in the NPPES registry for Tidewater Dental Pf is (410) 414-8333.
- Who is the authorized official for Tidewater Dental Pf?
- The authorized official listed on Tidewater Dental Pf's NPPES record is Connie Mccabe, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Tidewater Dental Pf's NPI active?
- Yes — Tidewater Dental Pf's NPI (1053607002) is active in the NPPES registry as of the last update on 2011-06-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.