Provider Demographics
NPI:1700825379
Name:SHAPIRO, SCOTT NATHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:NATHAN
Last Name:SHAPIRO
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 1:19300 DETROIT RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1847
Mailing Address - Country:US
Mailing Address - Phone:440-333-6353
Mailing Address - Fax:440-333-6358
Practice Address - Street 1:19300 DETROIT RD
Practice Address - Street 2:SUITE 206
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1847
Practice Address - Country:US
Practice Address - Phone:440-333-6353
Practice Address - Fax:440-333-6358
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH176881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice