Mika Matsumoto, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE61168232 Issued in WA

Practice address

14655 Bel-Red Road
Unit 101
Bellevue, WA 98007

Phone

(425) 641-4111

NPI assigned

Jun 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1624752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1891365433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4547 8TH AVE NE APT 509",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056707",
            "telephone_number": "808-292-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 BEL-RED ROAD",
            "address_2": "UNIT 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98007",
            "telephone_number": "425-641-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "MIKA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-27",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61168232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linneah Mathias, FNP-BC
• Patrick Leroy Mathiasen, MD
• Patricia A Mathis, ARNP
• Donna Rose Matney, O.D.
• Matrix Anesthesia, PS
• Toyo Matsumoto, D.D.S.
• Matt Rafie DDS PS
• Matthew S. Schroeder, OD, PLLC
• Kendall Marie Matthews, DPT, PT
• Linda Josephine Matthews

• Dentist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; 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.