MEDICARE: ZEALOUS DENTAL SPRINGDALE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1164294120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEALOUS DENTAL SPRINGDALE LLC

Provider Business Mailing Address
First Line	:	5938 WHITECRAIGS CT
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-9635
Country	:	US
Telephone Number	:	781-366-5004
Fax Number	:

Provider Business Practice Location Address
First Line	:	11711 PRINCETON PIKE UNIT 943
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-2500
Country	:	US
Telephone Number	:	513-214-0206
Fax Number	:	513-258-2542

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YUCHUN ZHANG
Credential	:	DDS
Telephone Number	:	781-366-5004

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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Directions to “ZEALOUS DENTAL SPRINGDALE LLC ” Practice Location

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