Provider Demographics
NPI:1275621484
Name:MIDKIFF, WILLIAM MARVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MARVIN
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 1:821 WALNUT FOREST COURT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322
Mailing Address - Country:US
Mailing Address - Phone:757-410-1893
Mailing Address - Fax:
Practice Address - Street 1:2149 OLD GREENBRIER RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-424-5822
Practice Address - Fax:757-413-5447
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist