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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: August 09, 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
Phone(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
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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 CMS claims · ZIP area

Typical Medicare office-visit costs in the 54935 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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 20

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

DR. MICHAEL DEAN CUNNINGHAM DDS
Dentist (Prosthodontics)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090
DR. RICHARD STERLING HARRIS DMD
Dentist
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090
TED HWANG
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090
DR. KENT ALAN ZOCHER DDS
Dentist (Pediatric Dentistry)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090
DR. DANIEL STRAND MAHN D.D.S.
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (414) 403-3731
DR. KURT WHITTET D.M.D.
Dentist (Orthodontics and Dentofacial Orthopedics)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090
MS. CAILYN LLOYD DDS
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090
DR. WILLIAM ALAN CAPUTO DMD
Dentist (General Practice)
545 E JOHNSON ST
FOND DU LAC, WI 54935
Fond Du Lac County (920) 924-9090

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 Courtney Miyamoto's NPI number?

The NPI number for Courtney Miyamoto is 1891271987. It was assigned to this individual provider in the NPPES registry on July 12, 2018.

Where is Courtney Miyamoto located?

Courtney Miyamoto practices at 545 E Johnson St, Fond Du Lac, WI 54935. The listed phone number is (920) 924-9090.

What is Courtney Miyamoto's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Courtney Miyamoto enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Courtney Miyamoto was last updated on October 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.