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General NPI Number Information
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NPI Number | 1003015926
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Entity Type | Individual
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Provider Name | SLAVA SHAPIRO DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/05/2010
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Provider Practice Location Address
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Address Line | 118 GREENWAY DR S
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City | SYOSSET
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State | NY
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Zip | 11791-3854
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Country | US
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Telephone | 917-837-8023
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Fax |
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Provider Business Mailing Address
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Address Line | 167 FROEHLICH FARM BLVD
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City | WOODBURY
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State | NY
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Zip | 11797-2906
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Country | US
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Telephone | 917-837-8023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 049812-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 049812-1
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License Number State | NY
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