DR. JOHN K. TIDWELL (NPI# 1003906835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003906835 |
| Entity Type | Individual |
| Full Name | DR. JOHN K. TIDWELL |
| Credential | DDS |
| Practice Address |
1801 Nw Market St Suite 108 Seattle WA 98107-3987 |
| Practice Telephone | 2067839672 |
| Practice Fax Number | 2067844812 |
| Mailing Telephone | 2067839672 |
| Mailing Fax Number | 2067844812 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DE00006884 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184885519 | John Edward Tidwell | Orthopaedic Surgery | 729 N Medical Center Dr W, Suite 111, Clovis, CA 93611-6879 | 2008-06-18 |
| 1790781805 | John W. Tidwell II | Obstetrics & Gynecology | 2801 Randolph Rd, Ste 200, Charlotte, NC 28211-1051 | 2005-06-23 |
| Street Address |
1801 NW MARKET ST SUITE 108 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98107-3987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952384711 | David Tadashi Aoyama | Internal Medicine | 1801 Nw Market St, Suite 309, Seattle, WA 98107-3987 | 2005-11-25 |
| 1780110064 | Dominick Curalli, Dds, Pllc | Dentist | 1801 Nw Market St, Ste 312, Seattle, WA 98107-3987 | 2017-05-05 |
| 1801334305 | William Ewing | Pharmacist | 1801 Nw Market St, 104, Seattle, WA 98107-3987 | 2017-02-03 |
| 1124479951 | Mena Salib | Family Medicine | 1801 Nw Market St, Seattle, WA 98107-3987 | 2016-06-22 |
| 1376923961 | Alexandra Duroc-danner | Massage Therapist | 1801 Nw Market St, Suite 408, Seattle, WA 98107-3987 | 2015-06-09 |
| 1821478686 | The Polyclinic | Allergy & Immunology | 1801 Nw Market St, Seattle, WA 98107-3987 | 2015-06-05 |
| 1457742660 | Carrie Hart | Massage Therapist | 1801 Nw Market St, Ste. 408, Seattle, WA 98107-3987 | 2015-02-10 |
| 1811385438 | Eileen Elizabeth Chang | Nurse Practitioner | 1801 Nw Market St, Seattle, WA 98107-3987 | 2015-01-05 |
| 1245668631 | John K Tidwell Dds Ps | Dentist | 1801 Nw Market St, Suite 108, Seattle, WA 98107-3987 | 2013-10-22 |
| 1457783029 | Ailee Marie Yates | Massage Therapist | 1801 Nw Market St, Seattle, WA 98107-3987 | 2013-08-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447897707 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1401 Nw 46th Street, 5th Floor, Seattle, WA 98107 | 2019-12-05 |
| 1619519493 | Charles Aljon Corpuz Agabin | Pharmacist | 1448 Nw Market Street, Suite 100, Seattle, WA 98107 | 2019-10-12 |
| 1427610682 | Dalillah Bernal Nord | Advanced Practice Midwife | 5300 Tallman Ave Nw Ste 420, Seattle, WA 98107 | 2019-07-08 |
| 1740849660 | Harmonic Healing LLC | Acupuncturist | 1551 Nw 54th Street Suite 204, Seattle, WA 98107 | 2019-06-13 |
| 1275198285 | Hsu Tsuchikawa and Wong Pllc | Clinic/Center | 1453 Nw 54th Street, Suite A, Seattle, WA 98107 | 2019-05-06 |
| 1801363502 | Bianca Marie Maggio | Physical Therapist | 5300 Tallman Ave, Outpatient Rehab Services 1-south, Seattle, WA 98107 | 2018-10-31 |
| 1831690726 | Sara Blackmur | Social Worker | 1417 Nw 54th St Ste 324, Seattle, WA 98107 | 2018-02-26 |
| 1225553159 | Jennifer Chain | Psychologist | 5306 Ballard Ave Nw Ste 212, Seattle, WA 98107 | 2017-08-11 |
| 1184148413 | John Julian Heal | Occupational Therapy Assistant | 5440 Leary Ave Nw, Unit 321, Seattle, WA 98107 | 2017-07-28 |
| 1710416169 | Heather Tracey Marie Osias | Social Worker | 2251 Nw 60th Street Apt B, Seattle, WA 98107 | 2017-06-08 |
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| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053875096 | John K Tidwell Dds and Elizabeth A Kutcipal Dds Pllc | Dentist | 1801 Nw Market St Ste 108, Seattle, WA 98107-3909 | 2019-01-23 |
| 1780151027 | Washington Jaw and Facial Surgery Pllc | Dentist | 2111 N Northgate Way Ste 105, Seattle, WA 98133-9018 | 2018-10-25 |
| 1952788150 | David J Haralson | Dentist | 509 Olive Way Ste 1331, Seattle, WA 98101-1743 | 2015-04-27 |
| 1912391350 | Li Han Lai | Dentist | Department of Oral Surgery 1959 Ne Pacific St, Health Sciences Building B-241, Seattle, WA 98195-0001 | 2015-03-24 |
| 1568693240 | Todd Paul Fairbanks | Dentist | University of Washington Oral Surgery Dept, Box 357134, 1959 Ne Pacific St., Seattle, WA 98195-7134 | 2009-07-29 |
| 1720292436 | Samuel Louis Bobek | Dentist | 600 Broadway Ste 460, Seattle, WA 98122-5312 | 2007-05-10 |
| 1669522546 | Thomas Stuart Maring | Dentist | 509 Olive Way Ste 550, Seattle, WA 98101-1736 | 2007-01-11 |
| 1093882185 | Darlene Michelle Chan | Dentist | 4744 41st Ave Sw Suite 107, Seattle, WA 98116-4566 | 2006-11-30 |
| 1750387361 | Thomas Howard Hohl | Dentist | 4540 Sand Point Way Ne, Ste 360, Seattle, WA 98105 | 2005-06-28 |
| 1750842415 | Brian H. Cheung, Dds, Md, Pllc | Dentist | 509 Olive Way Ste 1331, Seattle, WA 98101-1743 | 2019-03-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.