Provider Demographics
NPI:1194495317
Name:RICHARD H. MIYAMOTO, DDS
Entity type:Organization
Organization Name:RICHARD H. MIYAMOTO, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HIROSHI
Authorized Official - Last Name:MIYAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-596-2622
Mailing Address - Street 1:615 PIIKOI ST STE 1101
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3141
Mailing Address - Country:US
Mailing Address - Phone:808-596-2622
Mailing Address - Fax:808-596-2625
Practice Address - Street 1:615 PIIKOI ST STE 1101
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3141
Practice Address - Country:US
Practice Address - Phone:808-596-2622
Practice Address - Fax:808-596-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental