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DR. JOHN K. TIDWELL DDS
NPI 1003906835
Dentist - Oral and Maxillofacial Surgery in Seattle, WA

Active since October 13, 2006Opted out of Medicare · through Sep 1, 2026
1801 NW MARKET ST, SUITE 108, SEATTLE, WA 98107(206) 783-9672(206) 784-4812 Get Directions Write a Review

NPPES record last updated: October 22, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. John K. Tidwell Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN K. TIDWELL DDS (NPI 1003906835) is an individual oral and maxillofacial surgery provider in Seattle, Washington, licensed in Washington (DE00006884) and active in the NPI registry since October 2006. He has opted out of Medicare through September 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1003906835
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. JOHN K. TIDWELLCredential: DDS
Location Address1801 NW MARKET ST, SUITE 108Seattle, WA 98107-3987
Mailing Address1801 Nw Market St, Suite 108Seattle, WA 98107-3987 · (206) 783-9672 · Fax (206) 784-4812
Phone(206) 783-9672
Fax(206) 784-4812
Sole ProprietorNo
Enumeration DateOctober 13, 2006
Last NPPES UpdateOctober 22, 2013
✔ NPI 1003906835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in WA · DE00006884
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1801 NW MARKET ST, Seattle, WA 98107
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINU39521

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. John K. Tidwell Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 1, 2014 through September 1, 2026.

Opt-Out Effective DateSeptember 1, 2014
Opt-Out In Effect ThroughSeptember 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARY DAVID ROSEN M.D.
Family Medicine
1801 NW MARKET ST, SUITE 203
SEATTLE, WA 98107
King County (206) 781-6079
VINCENT T. CHAN MD
Otolaryngology
1801 NW MARKET ST, SUITE 411
SEATTLE, WA 98107
King County (206) 781-6072
TERESA LYNN GOEPFERT D. O.
Obstetrics & Gynecology
1801 NW MARKET ST, 207
SEATTLE, WA 98107
King County (206) 781-6161
JOHN R. BAGLEY LMP
Massage Therapist
1801 NW MARKET ST, SUITE 200
SEATTLE, WA 98107
King County (206) 784-2800
JOHN K TIDWELL DDS PS
Dentist (Oral and Maxillofacial Surgery)
1801 NW MARKET ST, SUITE 108
SEATTLE, WA 98107
King County (206) 783-9672
CYNTHIA BIRD JOHNSON M.D.
Family Medicine
1801 NW MARKET ST, SUITE 203
SEATTLE, WA 98107
King County (206) 781-6079
DR. RICHARD ALAN FOGERTY M.D.
Internal Medicine
1801 NW MARKET ST, SUITE 309
SEATTLE, WA 98107
King County (206) 784-0940
AUDREY K. ALLARD CNM
Advanced Practice Midwife
1801 NW MARKET ST, SUITE 207
SEATTLE, WA 98107
King County (206) 781-6080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Tidwell's NPI number?

The NPI number for John Tidwell is 1003906835. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is John Tidwell located?

John Tidwell practices at 1801 NW Market St Suite 108, Seattle, WA 98107. The listed phone number is (206) 783-9672.

What is John Tidwell's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is John Tidwell enrolled in Medicare?

No. John Tidwell has opted out of Medicare through September 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for John Tidwell was last updated on October 22, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.