Individual provider Active NPI

Slava Shapiro, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Syosset, NY
National Provider Identifier
1003015926
Registry record updated Jul 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
049812-1 Issued in NY
Practice address
118 Greenway Dr S
Syosset, NY 11791-3854
Phone
(917) 837-8023
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049812-1 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 049812-1 NY Primary

Addresses

Primary practice location

118 Greenway Dr S
Syosset, NY 11791-3854

Mailing address

167 Froehlich Farm Blvd
Woodbury, NY 11797-2906
Phone (917) 837-8023

Other identifiers 1

IdentifierTypeStateIssuer
02491569MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
049812-1NYMDOral and Maxillofacial Surgery (Dentist)

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: sshapiro1056104@nychhc.direct-ci.com
  • FHIR API: https://epicproxypda.nychhc.org/FHIRProxy/HOME/api/FHIR/R4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278288000000",
    "number": "1003015926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 FROEHLICH FARM BLVD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972906",
            "telephone_number": "917-837-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 GREENWAY DR S",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913854",
            "telephone_number": "917-837-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "SLAVA",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2010-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049812-1",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "049812-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02491569",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.