Healthcare Provider Details

I. General information

NPI: 1023227642
Provider Name (Legal Business Name): MARINA SHRAGA D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9868 S STATE ROAD 7 STE 200
BOYNTON BEACH FL
33472-4473
US

IV. Provider business mailing address

10149 WOODHAVEN BLVD STE 2
OZONE PARK NY
11416-2300
US

V. Phone/Fax

Practice location:
  • Phone: 561-462-1212
  • Fax:
Mailing address:
  • Phone: 917-797-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number27143
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number052174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: