Healthcare Provider Details

I. General information

NPI: 1871458455
Provider Name (Legal Business Name): ROSE IVANNA BRITNER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSE IVANNA JAEGER RDH

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S CLEVELAND AVE
HAGERSTOWN MD
21740-5745
US

IV. Provider business mailing address

201 S CLEVELAND AVE
HAGERSTOWN MD
21740-5745
US

V. Phone/Fax

Practice location:
  • Phone: 301-745-3777
  • Fax:
Mailing address:
  • Phone: 301-745-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number9179
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: