IndividualActive
Otto Tidwell, D.D.S.
NPI 1407803398 · Oral and Maxillofacial Surgery (Dentist) · Rehoboth Beach, DE
Provider details
- NPI number
- 1407803398
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- DS022622L (PA)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
19323 Lighthouse Plaza Blvd
Unit 4
Rehoboth Beach, DE 19971-6162
Phone: (302) 226-1606
Fax: (302) 226-1609
Approximate (ZIP-level) locationGet directions
Mailing address
19323 Lighthouse Plaza Blvd
Rehoboth Beach, DE 19971-6162
Registry dates
- Enumerated
- 2006-05-27
- Last updated
- 2014-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.