Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Bill Shayne Tidwell, DDS

Individual provider General Practice Dentistry · NPI 1053391797

Dr. Bill Shayne Tidwell, DDS is a General Practice Dentistry in Fort Defiance, Arizona. Practices as a sole proprietor. Licensed in Alaska, Colorado, Kansas and Texas.

Licensed in
AK, CO, KS, TX
In the registry since
2006
Specialties on file
4
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

Corner Of Route N12 And N7
Fort Defiance, AZ 86504-0589
Phone: (928) 729-8000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 6993 (KS)
General Practice Dentistry Taxonomy 1223G0001X · Licence 117592 (AK)
General Practice Dentistry Taxonomy 1223G0001X · Licence 7367 (CO)
General Practice Dentistry Taxonomy 1223G0001X · Licence 14581 (TX)

Record details

NPI number1053391797
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJanuary 19, 2006
Last updated in NPPESOctober 18, 2019

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