Provider Demographics
NPI:1003030545
Name:MIDKIFF, DAVID A (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:MIDKIFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 86TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-4207
Mailing Address - Country:US
Mailing Address - Phone:806-798-1145
Mailing Address - Fax:
Practice Address - Street 1:3315 64TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5741
Practice Address - Country:US
Practice Address - Phone:806-799-3191
Practice Address - Fax:806-797-4261
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice