DR. COURTNEY MIYAMOTO DDS
NPI 1891271987
Dentist - General Practice in Fond Du Lac, WI

Active since July 12, 2018PECOS Enrolled
545 E JOHNSON ST, FOND DU LAC, WI 54935(920) 924-9090 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 30, 2020, Jan 23, 2019, Jul 12, 2018 (3 updates tracked since 2018).

About Dr. Courtney Miyamoto Dds NPPES

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

DR. COURTNEY MIYAMOTO DDS (NPI 1891271987) is an individual general practice provider in Fond Du Lac, Wisconsin, licensed in Wisconsin (1001957) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1891271987
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. COURTNEY MIYAMOTOCredential: DDS
Location Address545 E JOHNSON STFond Du Lac, WI 54935-2856
Mailing Address545 E Johnson StFond Du Lac, WI 54935-2856 · (920) 924-9090
Sole ProprietorNo
Enumeration DateJuly 12, 2018
Last NPPES UpdateOctober 30, 20203 updates tracked since enumeration
NPPES CertifiedOctober 29, 2020
NPI 1891271987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses Licensed in WI · 1001957 Licensed in HI · DT2760
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

545 E JOHNSON ST, Fond Du Lac, WI 54935

Secondary Practice Locations 2

Location 11885 Main St Ste 203Wailuku, HI 96793-1827 · Phone (808) 242-7007
Location 22100 Miller Park WayWest Milwaukee, WI 53219-1641 · Phone (414) 645-4540

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. Courtney 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

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 54935 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.37
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $16.84
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (Periodontics)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist
545 E JOHNSON ST
FONDULAC, WI 54935
Dentist (Prosthodontics)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (Orthodontics and Dentofacial Orthopedics)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Clinic/Center (Dental)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (Periodontics)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891271987, enumerated as an "individual" on July 12, 2018.

The provider is located at 545 E JOHNSON ST FOND DU LAC, WI 54935 and the phone number is (920) 924-9090.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.