MEDICARE: SHAPIRO FAMILY DENTISTRY OF BOYNTON BEACH PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QD0000X	Dental Clinic/Center
2	261QS0112X	Oral and Maxillofacial Surgery Clinic/Center
3	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558831990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAPIRO FAMILY DENTISTRY OF BOYNTON BEACH PA

Provider Business Mailing Address
First Line	:	2247 PALM BEACH LAKES BLVD STE 105
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3408
Country	:	US
Telephone Number	:	561-254-2868
Fax Number	:	561-998-0901

Provider Business Practice Location Address
First Line	:	9868 S STATE ROAD 7 STE 200
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-4473
Country	:	US
Telephone Number	:	561-254-2868
Fax Number	:	561-998-0901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DARI SHAPIRO
Credential	:	DDS
Telephone Number	:	561-254-2868

Provider Enumeration Date	:	11/28/2018
Last Update Date	:	11/28/2018

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