npidexNPI registry + Medicare data

OTTO TIDWELL, D.D.S.

Oral and Maxillofacial Surgery (Dentist) · REHOBOTH BEACH, DE

Individual Active Opted out of Medicare NPI 1407803398

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Oral and Maxillofacial Surgery (Dentist)1223S0112X✓DS022622LPA
Oral and Maxillofacial Surgery (Dentist)1223S0112X22DIO1475500NJ

Medicare eligibility

Part B
Yes
DME
Yes
Home health
Yes
Power mobility
No
Hospice
Yes

Opted out of Medicare (Oral Surgery), effective 2025-01-01 through 2027-01-01.

Other Oral and Maxillofacial Surgery (Dentist) providers in Delaware

See all Oral and Maxillofacial Surgery (Dentist) providers in Delaware →

Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.