OrganizationActive
South Lake Family Dentistry
NPI 1275942518 · Dentist · Lake Stevens, WA
Provider details
- NPI number
- 1275942518
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Todd Miesel, Owner(425) 334-9600
- License
- 7981 (WA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10515 20th St Se
Suite 201
Lake Stevens, WA 98258-4764
Phone: (425) 334-9600
Fax: (425) 334-9900
Street-level locationGet directions
Mailing address
10515 20th St Se
Lake Stevens, WA 98258-4764
Registry dates
- Enumerated
- 2014-08-12
- Last updated
- 2014-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.