Provider Demographics
NPI:1518062231
Name:ZAIKOSKI, STACEY ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ELIZABETH
Last Name:ZAIKOSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5671 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2226
Mailing Address - Country:US
Mailing Address - Phone:937-293-6387
Mailing Address - Fax:937-293-1413
Practice Address - Street 1:5671 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2226
Practice Address - Country:US
Practice Address - Phone:937-293-6387
Practice Address - Fax:937-293-6387
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0243541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry