Provider Demographics
NPI:1265057483
Name:SHAPIRO, JESSICA ASHLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ASHLEY
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ASHLEY
Other - Last Name:SINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:407 BRIGHTON J
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4811
Mailing Address - Country:US
Mailing Address - Phone:516-642-1718
Mailing Address - Fax:
Practice Address - Street 1:1348 E HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4241
Practice Address - Country:US
Practice Address - Phone:954-719-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL249831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice