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DR. JOHN HIDEO MIZUKAWA II DDS
NPI 1104261023
Dentist - Oral and Maxillofacial Surgery in St George, UT

Active since May 06, 2013Opted out of Medicare · through Jan 1, 2027
1308 E 900 S STE A, ST GEORGE, UT 84790(435) 673-1554(435) 674-9967 Get Directions Write a Review

NPPES record last updated: February 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 8, 2023, Mar 17, 2018, Dec 4, 2017 (3 updates tracked since 2017).

About Dr. John Hideo Mizukawa Ii Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN HIDEO MIZUKAWA II DDS (NPI 1104261023) is an individual oral and maxillofacial surgery provider in St George, Utah, licensed in Utah (12918932) and active in the NPI registry since May 2013. He has opted out of Medicare through January 1, 2027 and remains eligible to order and refer and maintains a secondary practice location in Cedar City.

NPPES Registry Identity

NPI1104261023
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. JOHN HIDEO MIZUKAWA IICredential: DDS
Location Address1308 E 900 S STE ASt George, UT 84790-8730
Mailing Address1308 E 900 S Ste ASt George, UT 84790-8730 · (435) 673-1554 · Fax (865) 482-8686
Phone(435) 673-1554
Fax(435) 674-9967
Sole ProprietorNo
Enumeration DateMay 6, 2013
Last NPPES UpdateFebruary 8, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2023
✔ NPI 1104261023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in UT · 12918932
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1308 E 900 S STE A, St George, UT 84790
Open in Google Maps ↗

Secondary Practice Location 1

Location 1415 N Main St Ste 204Cedar City, UT 84721-6177 · Phone (435) 867-1474 · Fax (435) 867-1486

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. John Hideo Mizukawa Ii Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2023 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2023
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84790 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Mizukawa's NPI number?

The NPI number for John Mizukawa is 1104261023. It was assigned to this individual provider in the NPPES registry on May 6, 2013.

Where is John Mizukawa located?

John Mizukawa practices at 1308 E 900 S Ste A, St George, UT 84790. The listed phone number is (435) 673-1554.

What is John Mizukawa's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is John Mizukawa enrolled in Medicare?

No. John Mizukawa has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does John Mizukawa accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental PPO and 7 other insurers list John Mizukawa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Mizukawa was last updated on February 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.