Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shady Samuel

Individual provider Pediatric Dentistry · NPI 1245536382

Shady Samuel is a Pediatric Dentistry in Mineola, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2011
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

18 Jerome Ave
Mineola, NY 11501-3302
Phone: (718) 268-0452
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 055773 (NY)

Record details

NPI number1245536382
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 8, 2011
Last updated in NPPESAugust 15, 2017
Mailing address18 Jerome Ave, Mineola, NY 11501-3302

Other providers in Mineola