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Active NPI 1932131562 Individual Practitioner Male Practitioner

Dr. Eric Ivan Tidwell , DDS

Dentist - General Practice • Provo, UT

Professional Overview & Biography Verified Profile Summary

Dr. Eric Tidwell, DDS is a registered healthcare professional specializing in Dentist - General Practice in Provo, UT. Practice services are available at 777 N 500 W STE 101A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

777 N 500 W Ste 101a

Provo, UT 846011594

Telephone 8013736362
Fax 8013730115
Associated Practice Facility / Clinic
🏢 Rock Canyon Dentistry Facility NPI 1922474956

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Provo, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
61 Specialists

Practicing in Provo, UT (1388 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License UT 145165

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Public Employees Health
25762 (UT)
Commercial Insurance / Payer ID Aetn
0005877274 (UT)
Commercial Insurance / Payer ID Delta
145165UT (UT)
Commercial Insurance / Payer ID Deseret Mutual
23820 (UT)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Zachary Taylor , DDS

Dentist - General Practice

NPI 1407118490

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
✅
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 777 N 500 W STE 101A, PROVO, UT 846011594 (Tel: 8013736362)

📍
Updated Business Mailing Address July 08, 2007

Registered at 777 N 500 W STE 101A, PROVO, UT 846011594 (Tel: 8013736362)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as ERIC TIDWELL, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #145165 in UT)

🟢
Initial NPI Registration & Enumeration July 06, 2006

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: 1932131562
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

777 N 500 W Ste 101a

Provo, UT 846011594

Phone: 8013736362

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.