Healthcare Provider Details

I. General information

NPI: 1396670527
Provider Name (Legal Business Name): JONATHAN D MILES DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S MAIN ST
SMITHFIELD UT
84335-2306
US

IV. Provider business mailing address

510 S MAIN ST
SMITHFIELD UT
84335-2306
US

V. Phone/Fax

Practice location:
  • Phone: 435-563-3266
  • Fax: 435-563-3267
Mailing address:
  • Phone: 435-563-3266
  • Fax: 435-563-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN DAVID MILES
Title or Position: OWNER
Credential:
Phone: 435-232-6630