Provider Demographics
NPI:1467967299
Name:ZSL FAMILY DENTAL INC.
Entity Type:Organization
Organization Name:ZSL FAMILY DENTAL INC.
Other - Org Name:MANNHEIM DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-769-1288
Mailing Address - Street 1:2930 MANNHEIM RD STE 2
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2930 MANNHEIM RD STE 2
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2265
Practice Address - Country:US
Practice Address - Phone:847-451-9244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20171128531176Medicaid