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DR. DALE ROGER TIDABACK MD, MPH
NPI 1710963772
Preventive Medicine - Aerospace Medicine in Wright Patterson Afb, OH

Active since December 21, 2005
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433(703) 994-8148 Get Directions Write a Review

NPPES record last updated: December 2, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Dale Roger Tidaback Md, Mph NPPES

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

DR. DALE ROGER TIDABACK MD, MPH (NPI 1710963772) is an individual aerospace medicine provider in Wright Patterson Afb, Ohio, licensed in South Dakota (1559) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1710963772
Entity TypeIndividualMale
Primary Taxonomy2083A0100X
Provider Legal NameDR. DALE ROGER TIDABACKCredential: MD, MPH
Location Address4881 SUGAR MAPLE DRWright Patterson Afb, OH 45433-5529
Mailing Address9200 Armetale CtFairfax Station, VA 22039-3111 · (703) 690-1448
Phone(703) 994-8148
Sole ProprietorYes
Enumeration DateDecember 21, 2005
Last NPPES UpdateDecember 2, 2014
✔ NPI 1710963772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Aerospace MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083A0100X
License✔ Licensed in SD · 1559
Definition
Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 1559 (SD)
4881 SUGAR MAPLE DR, Wright Patterson Afb, OH 45433
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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.

MR. JAMES REBELLO III
Pharmacist
4881 SUGAR MAPLE DR
FAIRBORN, OH 45433
Greene County (937) 257-9014
CARLA HUELSKAMP PHARMD
Pharmacist
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-9696
JOHN ALAN ARTHUR
Internal Medicine
4881 SUGAR MAPLE DR
WPAFB, OH 45433
Greene County (937) 257-4482
ALEXIS D OWEN
Military Health Care Provider (Independent Duty Medical Technicians)
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-1574
GREGORY JAMES MORSE M.D.
Radiology (Nuclear Radiology)
4881 SUGAR MAPLE DR, 88 DTS/SGQX
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-9679
KENDRA M. SCHMUCK RD LD
Dietitian, Registered
4881 SUGAR MAPLE DR
WPAFB, OH 45433
Greene County (937) 257-8815
MATTHEW PHILIP SCULLY IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 45433
Greene County (616) 717-0169
KAREN LEWIS RTT
Radiologic Technologist (Radiation Therapy)
4881 SUGAR MAPLE DR, 88TH MDOS/SGOMR
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-4159

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 Dale Tidaback's NPI number?

The NPI number for Dale Tidaback is 1710963772. It was assigned to this individual provider in the NPPES registry on December 21, 2005.

Where is Dale Tidaback located?

Dale Tidaback practices at 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433. The listed phone number is (703) 994-8148.

What is Dale Tidaback's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Aerospace Medicine, with taxonomy code 2083A0100X.

When was this NPI record last updated?

The NPPES record for Dale Tidaback was last updated on December 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.