Steven a Miyamoto, DDS, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

42368 Issued in CA

Legal business name

STEVEN A MIYAMOTO, DDS, INC.

Practice address

113 W Amerige Ave
Fullerton, CA 92832-1856

Phone

(714) 525-1178

Fax

(714) 879-6235

NPI assigned

Jan 25, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Steven A Miyamoto, DDSNPI 1508039827

Title

Owner

Phone

(714) 525-1178

Specialties & licenses 1

Addresses

Other names 1

• Fullerton Oral Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven A Miyamoto, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fullerton, CA
  • NPI 1508039827
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1477090744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W AMERIGE AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321856",
            "telephone_number": "714-525-1178",
            "fax_number": "714-879-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W AMERIGE AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321856",
            "telephone_number": "714-525-1178",
            "fax_number": "714-879-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN A MIYAMOTO, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "MIYAMOTO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-525-1178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "42368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fullerton Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.