DR. TAKANARI MIYAMOTO DDS
NPI 1376730143
Dentist - Periodontics in La Vista, NE

Q: What is Takanari Miyamoto's NPI number?

The NPI number for Takanari Miyamoto is 1376730143. It was assigned to this individual provider in the NPPES registry on September 26, 2007.

Q: What is Takanari Miyamoto's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Takanari Miyamoto was last updated on May 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since September 26, 2007PECOS Enrolled

12110 PORT GRACE BLVD STE 202, LA VISTA, NE 68128(402) 614-7022(402) 614-7122 Get Directions Write a Review

NPPES record last updated: May 27, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Dr. Takanari Miyamoto Dds NPPES

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

DR. TAKANARI MIYAMOTO DDS (NPI 1376730143) is an individual periodontics provider in La Vista, Nebraska, licensed in Nebraska (6823) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376730143

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. TAKANARI MIYAMOTOCredential: DDS

Location Address12110 PORT GRACE BLVD STE 202La Vista, NE 68128-3190

Mailing Address12110 Port Grace Blvd Ste 202La Vista, NE 68128-3190

Phone(402) 614-7022

Fax(402) 614-7122

Sole ProprietorNo

Enumeration DateSeptember 26, 2007

Last NPPES UpdateMay 27, 2010

✔ NPI 1376730143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in NE · 6823

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

12110 PORT GRACE BLVD STE 202, La Vista, NE 68128

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Takanari Miyamoto Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68128 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

$81.20 typical visit price

range $52.69 – $160.21

Typical copayment $20.30 (range $13.17 – $40.05)

Most-billed visit code 99203

Established Patient

$66.00 typical visit price

range $16.90 – $131.25

Typical copayment $16.50 (range $4.22 – $32.81)

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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. BRETT JAMES CAWLEY D.D.S.

Dentist (Endodontics)

12110 PORT GRACE BLVD STE 202
LA VISTA, NE 68128

Sarpy County (402) 800-3557

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 Takanari Miyamoto's NPI number?

The NPI number for Takanari Miyamoto is 1376730143. It was assigned to this individual provider in the NPPES registry on September 26, 2007.

Where is Takanari Miyamoto located?

Takanari Miyamoto practices at 12110 Port Grace Blvd Ste 202, La Vista, NE 68128. The listed phone number is (402) 614-7022.

What is Takanari Miyamoto's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Takanari Miyamoto enrolled in Medicare?

Yes. Takanari Miyamoto is registered in the Medicare PECOS enrollment system.

What insurance does Takanari Miyamoto accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Nebraska, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Takanari Miyamoto 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 Takanari Miyamoto was last updated on May 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.