Provider Demographics
NPI:1912340019
Name:SHAPIRA, ERIC ZANE (DDS, MA, MHA)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ZANE
Last Name:SHAPIRA
Suffix:
Gender:M
Credentials:DDS, MA, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-0535
Mailing Address - Country:US
Mailing Address - Phone:650-619-1251
Mailing Address - Fax:
Practice Address - Street 1:2250 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3900
Practice Address - Country:US
Practice Address - Phone:415-922-3886
Practice Address - Fax:415-922-3883
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice