Provider Demographics
NPI:1598775520
Name:SHCHEGLOV, NAZAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAZAR
Middle Name:
Last Name:SHCHEGLOV
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 1:129 CLOVE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5223
Mailing Address - Country:US
Mailing Address - Phone:845-223-3050
Mailing Address - Fax:845-223-5350
Practice Address - Street 1:129 CLOVE BRANCH RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-5223
Practice Address - Country:US
Practice Address - Phone:845-223-3050
Practice Address - Fax:845-223-5350
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052094-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist