Provider Demographics
NPI:1669750105
Name:SHAPIRO, HAROLD L
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:L
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 DUKE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2990
Mailing Address - Country:US
Mailing Address - Phone:703-751-4344
Mailing Address - Fax:703-461-3250
Practice Address - Street 1:5249 DUKE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2990
Practice Address - Country:US
Practice Address - Phone:703-751-4344
Practice Address - Fax:703-461-3250
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist