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Tidewater LLC

Dentist in Glen Burnie, MD · enumerated 2023 · authorized official Simone Wilson-Adeleke, Director of Credentialing & Enroll.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1760171060

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Registry record

Entity type Organization (Type 2)
Legal business name Tidewater LLC
Parent organization Tidewater, LLC
Practice address 1720 Crain Hwy S Ste 103, Glen Burnie, MD, 21061
Phone (410) 761-0095
Enumeration date May 2, 2023
Last updated in NPPES May 2, 2023

Taxonomy & classification

122300000X Dentist Dental Providers Primary

Authorized official

Name Simone Wilson-Adeleke
Title Director of Credentialing & Enroll
Phone (848) 326-8840

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Tidewater LLC?
The NPI for Tidewater LLC is 1760171060, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Tidewater LLC?
NPPES lists Simone Wilson-Adeleke (Director of Credentialing & Enroll) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-05-02.