Healthcare Provider Details

I. General information

NPI: 1487573721
Provider Name (Legal Business Name): MICHAEL T. MIYAMOTO DDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI ST STE 1101
HONOLULU HI
96814-3141
US

IV. Provider business mailing address

615 PIIKOI ST STE 1101
HONOLULU HI
96814-3141
US

V. Phone/Fax

Practice location:
  • Phone: 808-596-2622
  • Fax: 808-596-2625
Mailing address:
  • Phone: 808-596-2622
  • Fax: 808-596-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TADAYUKI MIYAMOTO
Title or Position: PROSTHODONTIST/OWNER
Credential: DDS
Phone: 808-351-5148