Provider Demographics
NPI:1982231635
Name:BRINSFIELD, MACKENZIE DARLENE (RDH)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:DARLENE
Last Name:BRINSFIELD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:DARLENE
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:FEDERALSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21632-1012
Mailing Address - Country:US
Mailing Address - Phone:410-754-7583
Mailing Address - Fax:833-916-1013
Practice Address - Street 1:215 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:FEDERALSBURG
Practice Address - State:MD
Practice Address - Zip Code:21632-1012
Practice Address - Country:US
Practice Address - Phone:410-754-7583
Practice Address - Fax:833-916-1013
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8007124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist