Provider Demographics
NPI:1265709646
Name:SHAPIRO, BRUCE RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:RICHARD
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 M ST NW
Mailing Address - Street 2:B-130
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5802
Mailing Address - Country:US
Mailing Address - Phone:202-463-8376
Mailing Address - Fax:301-229-8435
Practice Address - Street 1:1800 M ST NW
Practice Address - Street 2:B-130
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5802
Practice Address - Country:US
Practice Address - Phone:202-463-8376
Practice Address - Fax:301-229-8435
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN38681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice