Healthcare Provider Details

I. General information

NPI: 1154231348
Provider Name (Legal Business Name): OLGA SHAPOSHNIKOV DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 HUDSON ST APT 1C
NEW YORK NY
10014-3254
US

IV. Provider business mailing address

535 HUDSON ST APT 1C
NEW YORK NY
10014-3254
US

V. Phone/Fax

Practice location:
  • Phone: 646-852-6890
  • Fax:
Mailing address:
  • Phone: 646-852-6890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. OLGA SHAPOSHNIKOV
Title or Position: OWNER
Credential: DDS
Phone: 646-852-6890