Active NPI
David Minoru Miyatake, DDS
- Dentist
- Maple Valley, WA
National Provider Identifier
1124351630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00005666
- Practice address
- 22626 SE 216TH PL
Maple Valley, WA 98038-6446 - Phone
- (425) 432-3382
- NPI assigned
- Sep 15, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00005666 | WA | Primary |
Addresses
Primary practice location
22626 SE 216TH PL
Maple Valley, WA 98038-6446
Mailing address
22626 SE 216TH PL
Maple Valley, WA 98038-6446
Phone (425) 432-3382
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00005666 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252972800000",
"number": "1124351630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22626 SE 216TH PL",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980386446",
"telephone_number": "425-432-3382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22626 SE 216TH PL",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980386446",
"telephone_number": "425-432-3382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIYATAKE",
"first_name": "DAVID",
"middle_name": "MINORU",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-15",
"last_updated": "2009-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00005666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.