Active NPI
Carole Miyahara
- Pediatric Dentistry
- Berkeley, CA
National Provider Identifier
1831492404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DT39047
- Practice address
- 3010 Colby Street
Suite 217
Berkeley, CA 94705-2059 - Phone
- (510) 848-6494
- NPI assigned
- Dec 21, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DT39047 | CA | Primary |
Addresses
Primary practice location
3010 Colby Street
Suite 217
Berkeley, CA 94705-2059
Mailing address
3010 Colby St
Suite 217
Berkeley, CA 94705-2091
Phone (510) 848-6494
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 |
|---|---|---|---|
| DT39047 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Katsura Khalil Nakazato Khosrovani DDS Inc. | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Berkeley, CA
- NPI 1043340227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1831492404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 COLBY ST",
"address_2": "SUITE 217",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052091",
"telephone_number": "510-848-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 COLBY STREET",
"address_2": "SUITE 217",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052059",
"telephone_number": "510-848-6494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIYAHARA",
"first_name": "CAROLE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-21",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "DT39047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.