Provider Demographics
NPI:1467546895
Name:NERIO, JEFF (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:NERIO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 39TH AVE SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3690
Mailing Address - Country:US
Mailing Address - Phone:253-845-5456
Mailing Address - Fax:253-848-0141
Practice Address - Street 1:315 39TH AVE SW
Practice Address - Street 2:SUITE 1
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3690
Practice Address - Country:US
Practice Address - Phone:253-845-5456
Practice Address - Fax:253-848-0141
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000071191223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics