Alisha Diane Brennen, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

16215 Issued in MD

Practice address

10201 Martin Luther King Jr Hwy Unit 240a
Bowie, MD 20720-4003

Phone

(240) 764-5753

Fax

(240) 764-5799

NPI assigned

Feb 8, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: areynolds912748@direct.umm.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bright Starr Pediatric Dentistry, LLC

  • Dental Clinic/Center
  • Bowie, MD
  • NPI 1568113082
  NPD
• Winifred J Booker DDS PA

  • Pediatric Dentistry
  • Owings Mills, MD
  • NPI 1164635777
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1942748140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 TOLEDO TER APT 320",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207824207",
            "telephone_number": "952-262-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 MARTIN LUTHER KING JR HWY UNIT 240A",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204003",
            "telephone_number": "240-764-5753",
            "fax_number": "240-764-5799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9199 Reisterstown Rd Ste 203A",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "21117",
            "country_code": "US",
            "telephone_number": "410-356-8571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9199 Reisterstown Rd Ste 203A",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "21117",
            "country_code": "US",
            "telephone_number": "410-356-8571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNEN",
        "first_name": "ALISHA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16215",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "16215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800126350",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika D Bramlette, PA
• Eric F Branch
• Angela Harrison Brantley, MD
• Briana Renee Brazziel
• Breem Healthcare Services
• Sierra Brewer
• Katrina Renise Brickhouse, LICSW
• Bright Healthcare Services, LLC
• Bright Life ABA MD
• Bright Starr Pediatric Dentistry, LLC

• Pediatric Dentistry in Bowie, MD
• Providers in Bowie, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.