Matthew Ryuichi Miyamoto

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

62436 Issued in KS

Practice address

13101 W 133Rd CT Apt 7313
Overland Park, KS 66213-5211

Phone

(808) 266-0388

NPI assigned

Oct 1, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Matt Ryuichi Miyamoto Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1518831718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13101 W 133RD CT APT 7313",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662135211",
            "telephone_number": "808-266-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13101 W 133RD CT APT 7313",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662135211",
            "telephone_number": "808-266-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYAMOTO",
        "first_name": "MATTHEW",
        "middle_name": "RYUICHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "62436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATT",
            "last_name": "MIYAMOTO",
            "middle_name": "RYUICHI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maureen Julia Mitchell, RPT
• Brittany Vaughn Mitchelson, MS, BCBA, LBA
• James Aaron Mitchum, LCPC
• Alex David Mitts
• James A Mitts, DO
• Kristen Marie Mize, PHARMD
• Brendon Lee Mizner, PT, DPT
• Benyamine Mizrahi, M.D.
• Diana Vasselle Mladenoff, DC
• Evan Mladenoff, D.C.

• General Practice Dentistry in Overland Park, KS
• Providers in Overland Park, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.