Provider Demographics
NPI:1588653182
Name:SCHAPIRO, JERROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERROLD
Middle Name:
Last Name:SCHAPIRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5813
Mailing Address - Country:US
Mailing Address - Phone:315-724-1324
Mailing Address - Fax:315-735-3183
Practice Address - Street 1:2404 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5813
Practice Address - Country:US
Practice Address - Phone:315-724-1324
Practice Address - Fax:315-735-3183
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0379491223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics