Individual provider · Type 1 NPI

Bill Shayne Tidwell, DDS

General Practice Dentistry · Fort Defiance, AZ

NPI number 1053391797 Active

Practice location

Corner Of Route N12 And N7
Fort Defiance, AZ 86504-0649

Call (928) 729-8000 Map

Mailing address

PO Box 1801
Fort Defiance, AZ 86504-1801

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XDEN.00007367 (CO)
General Practice Dentistry 1223G0001X117592 (AK)
General Practice Dentistry 1223G0001X6993 (KS)
General Practice Dentistry 1223G0001X14581 (TX)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1053391797

Bill Shayne Tidwell, DDS's National Provider Identifier is 1053391797, issued on Jan 19, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Fort Defiance, AZ. The record was last updated on Oct 5, 2026.