DR. MIKA MIYAMOTO (DMD) – General Practice Dentistry, NPI 1891792271
General Practice Dentistry
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MIKA MIYAMOTO (DMD)
500 NW 10TH AVE
PORTLAND, OR 972093364
Phone: (503) 977-3275
Fax: (503) 546-3014
Type: Location
Tower Plastics, 1211, Northwest Glisan Street, Pearl District, Portland, Metro, Multnomah County, Oregon, 97209, United States
SUITE 201
PORTLAND, OR 972093054
Phone: (503) 977-3275
Fax: (503) 546-3014
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $86.
Total Amount is formed as General ($86) + Research ($0) + Ownership ($0) = $86.
Last reported payment date: 2024-07-24 • Largest payer in this snapshot: OraPharma, a division of Bausch Health US, LLC ($40).
Total Amount
$86
General + Research + Ownership
Payments
5
Total payment records
General Amount
$86
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-04-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240421000151 | I | Dentist | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97209)
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Reviews
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