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JOHN K TIDWELL DDS PS NPI 1245668631


NPI Information

NPI: 1245668631
Provider Name: JOHN K TIDWELL DDS PS

Other Name: BALLARD ORAL AND MAXILLOFACIAL SURGERY

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1801 NW MARKET ST
SUITE 108
SEATTLE, WA
ZIP 98107
Phone: (206) 783-9672
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JOHN K TIDWELL DDS PS is an oral and maxillofacial surgery dentist in Seattle, WA. The provider is 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. JOHN K TIDWELL DDS PS NPI is 1245668631. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Ballard Oral And Maxillofacial Surgery.

The provider's business location address is:

1801 NW MARKET ST
SUITE 108
SEATTLE, WA
ZIP 98107-987
Phone: (206) 783-9672

The provider's authorized official is Elizabeth Barnes .
The authorized official title is Manager and has the following contact phone number (206) 783-9672.

The enumeration date for this NPI number is 10/22/2013 and was last updated on 10/22/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryDE00006884WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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