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General NPI Number Information
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NPI Number | 1548882939
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Entity Type | Individual
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Provider Name | RACHEL ELIZABETH BREINING DDS
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Gender | Female
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 119 E MAIN ST
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City | LITTLE CHUTE
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State | WI
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Zip | 54140-1850
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Country | US
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Telephone | 920-735-9366
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 DUBLIN TRL APT 46
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City | NEENAH
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State | WI
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Zip | 54956-6920
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Country | US
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Telephone | 920-385-3185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | R781
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1002532
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License Number State | WI
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