Anthony C. Tidwell, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

142661 Issued in UT

Practice address

4110 Highland Dr
Suite #200
Salt Lake City, UT 84124-2676

Phone

(801) 278-1164

Fax

(801) 274-0124

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Olympus View Dental

  • Dentist
  • Salt Lake City, UT
  • NPI 1598845950
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992885404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 HIGHLAND DR",
            "address_2": "SUITE #200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242676",
            "telephone_number": "801-278-1164",
            "fax_number": "801-274-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 HIGHLAND DR",
            "address_2": "SUITE #200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242676",
            "telephone_number": "801-278-1164",
            "fax_number": "801-274-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "ANTHONY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "142661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tian Tian
• Whitney Ann Tiatia
• Mary Tibbitts
• Catherine Nolan Tibbs, TRS/CTRS
• Edis Hazel Ticas Gomez
• Heidi Gretchen Tidwell
• Sara Lee Tidwell, M.S., CCC-A
• Alicia Jeanne Tiernan
• Ty J. Tietjen, MD
• Christopher C. Tietze, MD

• Dentist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.