Provider Demographics
NPI:1972956423
Name:MILES F. NEFF, DDS
Entity type:Organization
Organization Name:MILES F. NEFF, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:F
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-252-0111
Mailing Address - Street 1:3230 COLBY AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4399
Mailing Address - Country:US
Mailing Address - Phone:425-252-0111
Mailing Address - Fax:425-252-1119
Practice Address - Street 1:3230 COLBY AVE STE 3
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4399
Practice Address - Country:US
Practice Address - Phone:425-252-0111
Practice Address - Fax:425-252-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA52981223G0001X
WA4260124Q00000X
WA4909124Q00000X
WA4741124Q00000X
WA60055086126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5552609Medicaid
WA0043424OtherL & I