Provider Demographics
NPI:1144489337
Name:SHAPOSHNIKOV, OLGA (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:SHAPOSHNIKOV
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 HUDSON ST APT 1E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3254
Mailing Address - Country:US
Mailing Address - Phone:646-852-6890
Mailing Address - Fax:
Practice Address - Street 1:535 HUDSON ST APT 1E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3254
Practice Address - Country:US
Practice Address - Phone:646-852-6890
Practice Address - Fax:646-390-5046
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051707122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist