Provider Demographics
NPI:1265980692
Name:KEITH N YOSHINO DDS LTD
Entity type:Organization
Organization Name:KEITH N YOSHINO DDS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:N
Authorized Official - Last Name:YOSHINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-657-0660
Mailing Address - Street 1:3711 CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3801
Mailing Address - Country:US
Mailing Address - Phone:847-657-0660
Mailing Address - Fax:847-657-0878
Practice Address - Street 1:3711 CENTRAL RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3801
Practice Address - Country:US
Practice Address - Phone:847-657-0660
Practice Address - Fax:847-657-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL319011504122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1891818720OtherNIS