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DR. OTTO FREDERICK TIDWELL D.D.S.
NPI 1407803398
Dentist - Oral and Maxillofacial Surgery in Rehoboth Beach, DE

Active since May 27, 2006Opted out of Medicare · through Jan 1, 2027
19323 LIGHTHOUSE PLAZA BLVD, UNIT 4, REHOBOTH BEACH, DE 19971(302) 226-1606(302) 226-1609 Get Directions Write a Review

NPPES record last updated: January 14, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Otto Frederick Tidwell D.d.s. NPPES

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

DR. OTTO FREDERICK TIDWELL D.D.S. (NPI 1407803398) is an individual oral and maxillofacial surgery provider in Rehoboth Beach, Delaware, licensed in Pennsylvania (DS022622L) and active in the NPI registry since May 2006. He has opted out of Medicare through January 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407803398
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. OTTO FREDERICK TIDWELLCredential: D.D.S.
Location Address19323 LIGHTHOUSE PLAZA BLVD, UNIT 4Rehoboth Beach, DE 19971-6162
Mailing Address19323 Lighthouse Plaza Blvd, Unit 4Rehoboth Beach, DE 19971-6162 · (215) 880-9919 · Fax (215) 557-8551
Phone(302) 226-1606
Fax(302) 226-1609
Sole ProprietorYes
Enumeration DateMay 27, 2006
Last NPPES UpdateJanuary 14, 2014
✔ NPI 1407803398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in PA · DS022622L✔ Licensed in NJ · 22DIO1475500
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.
19323 LIGHTHOUSE PLAZA BLVD, Rehoboth Beach, DE 19971
Open in Google Maps ↗

Other Identifiers 2

Other121367PA · United Concordia Provider
Other0060881000PA · Blue Cross Provider Numbe

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

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. Otto Frederick Tidwell D.d.s. 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 January 1, 2025 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2025
Opt-Out In Effect ThroughJanuary 1, 2027Opt-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 19971 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
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
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

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

SOUTHERN DELAWARE ASSOCIATES OF DENTAL SPECIALITIES
Clinic/Center (Oral and Maxillofacial Surgery)
19323 LIGHTHOUSE PLAZA BLVD, UNIT 4
REHOBOTH BEACH, DE 19971
Sussex County (215) 880-9919

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 Otto Tidwell's NPI number?

The NPI number for Otto Tidwell is 1407803398. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Where is Otto Tidwell located?

Otto Tidwell practices at 19323 Lighthouse Plaza Blvd Unit 4, Rehoboth Beach, DE 19971. The listed phone number is (302) 226-1606.

What is Otto Tidwell's specialty?

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

Is Otto Tidwell enrolled in Medicare?

No. Otto Tidwell has opted out of Medicare through January 1, 2027. 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.

What insurance does Otto 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, Florida Combined Life and Highmark Blue Cross Blue Shield Delaware list Otto 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 Otto Tidwell was last updated on January 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.