Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. TAKANARI MIYAMOTO, DDS
ActiveDR. TAKANARI MIYAMOTO, DDS is a Periodontology healthcare provider located in LA VISTA, Nebraska. NPI 1376730143 is currently active in the NPPES registry. Verify at CMS.
Periodontology · LA VISTA, NE
Registration Details
- NPI Number
- 1376730143
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 26, 2007 (18.906667541524 yrs)
- Last Updated
- May 27, 2010
- License
-
6823 (NE)
Practice Information
- Address
-
12110 PORT GRACE BLVD STE 202LA VISTA, NE, 681283190Browse NE providers · Browse ZIP 68128
- Phone
- 4026147022
- Fax
- 4026147122
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.