Provider Demographics
NPI:1184146896
Name:BRUMMERHOP, ALEXANDRA (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:BRUMMERHOP
Suffix:
Gender:
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HERFF RD STE 106
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2676
Mailing Address - Country:US
Mailing Address - Phone:830-461-5554
Mailing Address - Fax:830-461-5610
Practice Address - Street 1:116 HERFF RD STE 106
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2676
Practice Address - Country:US
Practice Address - Phone:830-461-5554
Practice Address - Fax:830-461-5610
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33290122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No122300000XDental ProvidersDentist