JENNIFER ANN BRUNACINI


Address: 284 Cumberland Ave., Portland High School, Amanda Rowe Health Clinic, Portland, ME 04101
Phone: 2078424653

JENNIFER ANN BRUNACINI (NPI# 1467681601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467681601
Entity Type Individual
Full Name JENNIFER ANN BRUNACINI
Other Name JENNIFER ANN FULTZ
Credential DDS
Practice Address 284 Cumberland Ave.
Portland High School, Amanda Rowe Health Clinic
Portland
ME 04101
Mailing Address 389 Congress St.
The City of Portland, Public Health Division
Portland
ME 04101
Practice Telephone 2078424653
Practice Fax Number 2078288802
Mailing Telephone 2078748944
Mailing Fax Number 2078748913
Enumeration Date 2009-07-09
Last Update Date 2015-01-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist DEN4114 ME Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
ME 434739499 05

Office Location

Street Address 284 CUMBERLAND AVE.
PORTLAND HIGH SCHOOL, AMANDA ROWE HEALTH CLINIC
City PORTLAND
State ME
Zip Code 04101

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1144733064 Alixandria Elaine Marie Winchell Massage Therapist One City Center, Portland, ME 04101 2017-11-14
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1023538154 Derina Boothroyd Audiologist-Hearing Aid Fitter 985 Forest Ave., Portland, ME 04101 2017-06-20
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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

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1255975561 Michigan Sleep Solutions LLC Dentist 8037 Abbey Rd., Portland, MI 48875-9774 2019-10-30
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1255989497 Owen Ritter Lund Dentist 4224 Ne Halsey St Ste 330, Portland, OR 97213-1568 2019-08-30
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1598223919 Portland Modern Dentistry Dentist 5175 Ne Martin Luther King Blvd Ste 110, Portland, OR 97211-3233 2019-03-05
1922571942 Rashmi, LLC Dentist 553 Portland Cobalt Rd Unit 1, Portland, CT 06480-1968 2019-01-03
1053891051 Waleed Almulla Dentist 8401 Ne Halsey St Ste 102, Portland, OR 97220-5670 2018-08-19
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Competitor

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City PORTLAND
Zip Code 04101

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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