DR. BILL SHAYNE TIDWELL DDS
NPI 1053391797
Dentist - General Practice in Fort Defiance, AZ
About Dr. Bill Shayne Tidwell Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BILL SHAYNE TIDWELL DDS (NPI 1053391797) is an individual general practice provider in Fort Defiance, Arizona, licensed in Kansas (6993) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Bill Shayne Tidwell Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 86504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
FORT DEFIANCE, AZ 86504
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 Bill Tidwell's NPI number?
The NPI number for Bill Tidwell is 1053391797. It was assigned to this individual provider in the NPPES registry on January 19, 2006.
Where is Bill Tidwell located?
Bill Tidwell practices at Corner Of Route N12 And N7, Fort Defiance, AZ 86504. The listed phone number is (928) 729-8000.
What is Bill Tidwell's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Bill Tidwell enrolled in Medicare?
Yes. Bill Tidwell is registered in the Medicare PECOS enrollment system.
What insurance does Bill Tidwell accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Guardian list Bill Tidwell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Bill Tidwell was last updated on October 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Bill Shayne Tidwell, DDS · NPI 1053391797
General Practice provider in Fort Defiance, Arizona. Individual provider, active in the CMS NPPES registry since January 19, 2006.
## Identity
- **NPI:** 1053391797 (Entity type: Individual)
- **Enumerated:** January 19, 2006
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 6993 (Kansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** CORNER OF ROUTE N12 AND N7, Fort Defiance, AZ 86504-0589
- **Phone:** (928) 729-8000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
## Record status
- **NPPES last updated:** October 18, 2019
- **Other identifiers:** Medicaid 100454590A (KS); Other 48-1181104
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Source: [NPI Profile](https://npiprofile.com/npi/1053391797) · Data from the CMS NPPES public registry.