Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1770272163 Individual Practitioner Male Practitioner

Dr. Tyler Keith Stidham , DMD, MBA

Dentist • Fernandina Beach, FL

Professional Overview & Biography Verified Profile Summary

Dr. Tyler Stidham, DMD, MBA is a registered healthcare professional specializing in Dentist in Fernandina Beach, FL. Practice services are available at 516 ISLAND VIEW DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

516 Island View Dr

Fernandina Beach, FL 320340099

Telephone 7409354258

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Fernandina Beach, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.2 Yrs
Regional Practice Density
8 Specialists

Practicing in Fernandina Beach, FL (6414 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-11-03
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License FL DN29186

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License OH 30.027614

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location November 03, 2025

Registered at 516 ISLAND VIEW DR, FERNANDINA BEACH, FL 320340099 (Tel: 7409354258)

📍
Updated Business Mailing Address November 03, 2025

Registered at 516 ISLAND VIEW DR, FERNANDINA BEACH, FL 320340099 (Tel: 7409354258)

📍
Updated Practice Location June 12, 2024

Registered at 8714 TENNYSON AVE, WHEELERSBURG, OH 456941932 (Tel: 7403701992)

📍
Updated Business Mailing Address June 12, 2024

Registered at 2628 CLOVERLANE DR, WHEELERSBURG, OH 456949497 (Tel: 7409354258)

👤
Provider Name / Credentials Updated June 12, 2024

Recorded as TYLER STIDHAM, DMD, MBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 12, 2024

Dentist (License #30.027614 in OH)

NPI Profile Active May 02, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location May 02, 2023

Registered at 3528 BARTER ST, SAINT CHARLES, MO 633018155 (Tel: 7409354258)

📍
Updated Business Mailing Address May 02, 2023

Registered at 3528 BARTER ST, SAINT CHARLES, MO 633018155 (Tel: 7409354258)

👤
Provider Name / Credentials Updated May 02, 2023

Recorded as TYLER STIDHAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 02, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 02, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770272163
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 02, 2023
Last Update: November 03, 2025
Sole Proprietor: Yes

Mailing Address

516 Island View Dr

Fernandina Beach, FL 320340099

Phone: 7409354258

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.