Provider Demographics
NPI:1316679095
Name:SITZMAN, MACKENZIE RYAN (DMD)
Entity type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:RYAN
Last Name:SITZMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 CARTI WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6523
Mailing Address - Country:US
Mailing Address - Phone:501-906-3000
Mailing Address - Fax:
Practice Address - Street 1:8901 CARTI WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6523
Practice Address - Country:US
Practice Address - Phone:501-906-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4614122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist