Provider Demographics
NPI:1114810249
Name:TATE, JOEL (DDS)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:TATE
Suffix:
Gender:X
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11834 OLD NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6118
Mailing Address - Country:US
Mailing Address - Phone:240-578-5672
Mailing Address - Fax:
Practice Address - Street 1:11834 OLD NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6118
Practice Address - Country:US
Practice Address - Phone:240-578-5672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD186811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice