Healthcare Provider Details

I. General information

NPI: 1205570876
Provider Name (Legal Business Name): AYANNA BRINEA POWELL RDH,DHSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AYANNA BRINEA WOOD RDH

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 GARDEN CITY DR
LANDOVER MD
20785-2223
US

IV. Provider business mailing address

4351 GARDEN CITY DR
LANDOVER MD
20785-2223
US

V. Phone/Fax

Practice location:
  • Phone: 202-615-3052
  • Fax:
Mailing address:
  • Phone: 202-615-3052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number5352
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number8398
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: