Provider Demographics
NPI:1548665201
Name:BRUNMEIER, RACHEL ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANN
Last Name:BRUNMEIER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:STATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:95-061 WAIKALANI DR APT 1103
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3315
Mailing Address - Country:US
Mailing Address - Phone:248-495-7111
Mailing Address - Fax:
Practice Address - Street 1:2104 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2232
Practice Address - Country:US
Practice Address - Phone:808-949-6608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-2554122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist