MEDICARE: DR. AYANNA BRINEA POWELL RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	5352	LA
2	124Q00000X	Dental Hygienist	8398	MD

General Provider Information

NPI Number	:	1205570876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AYANNA BRINEA POWELL RDH

Provider Business Mailing Address
First Line	:	4351 GARDEN CITY DR
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-2223
Country	:	US
Telephone Number	:	202-615-3052
Fax Number	:

Provider Business Practice Location Address
First Line	:	3709 MASONIC DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-3632
Country	:	US
Telephone Number	:	318-269-6422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	06/10/2026

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