Provider Demographics
NPI:1659474229
Name:ANDERSON, RACHEL MIYOKO (DMD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MIYOKO
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 557 BOX 3056
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3D DENBN/USNDC
Practice Address - Street 2:UNIT 38450
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96604
Practice Address - Country:US
Practice Address - Phone:098-645-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 2273122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist