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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. BILL SHAYNE TIDWELL, DDS

Active Sole Proprietor

DR. BILL SHAYNE TIDWELL, DDS is a General Dentistry healthcare provider located in FORT DEFIANCE, Arizona. NPI 1053391797 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · FORT DEFIANCE, AZ

Registration Details

NPI Number
1053391797
Provider Type
Individual
Gender
Male
NPI Issued
Jan 19, 2006 (20.548060578625 yrs)
Last Updated
Oct 18, 2019
Licenses
117592 (AK)
7367 (CO)
14581 (TX)
6993 (KS)
Sole Proprietor
Yes

Practice Information

Address
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ, 865040589
Browse AZ providers · Browse ZIP 86504
Phone
9287298000
Primary Specialty
General Dentistry
1223G0001X
Additional Specialty
General Dentistry
Additional Specialty
General Dentistry
Additional Specialty
General Dentistry

Other General Dentistry Providers in FORT DEFIANCE, AZ

Name Credential NPI
DR. DEXTER P INNISS D.M.D 1629146469
DAVID ALLEN FLEMING DDS 1720121734
DR. LELAND JAMES POND JR. D.M.D 1710110515
DR. CHRISTINE A RIZKALLA DMD 1518308584
DR. ETHAN D CHASE DMD 1720479892
DANIEL STRATTON HULTGREN 1821518275
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.