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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SHINE PEDIATRIC DENTISTRY
NPI 1104758317
Dentist - Pediatric Dentistry in Bayside, NY

Active since June 01, 2026
20012 44TH AVE, BAYSIDE, NY 11361(929) 389-1663 Get Directions Write a Review

NPPES record added: June 1, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shine Pediatric Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHINE PEDIATRIC DENTISTRY (NPI 1104758317) is a healthcare organization registered as a pediatric dentistry in Bayside, New York and active in the NPI registry since June 2026. The organization lists Elliot Abraham Shine, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104758317
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameSHINE PEDIATRIC DENTISTRY
Location Address20012 44TH AVEBayside, NY 11361-2537
Mailing Address16 Martin CtGreat Neck, NY 11024-1620 · (516) 695-0103
Phone(929) 389-1663
Organization SubpartNo
Authorized OfficialElliot Abraham ShineCeo · (516) 695-0103
Enumeration DateJune 1, 2026
NPPES CertifiedJune 1, 2026
✔ NPI 1104758317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
20012 44TH AVE, Bayside, NY 11361
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES A RAND MD LLC
Internal Medicine (Gastroenterology)
20012 44TH AVE, 3RD FLOOR
BAYSIDE, NY 11361
Queens County (718) 224-7454
JAMES RAND M.D.
Internal Medicine (Gastroenterology)
20012 44TH AVE, 3RD FLOOR
BAYSIDE, NY 11361
Queens County (718) 224-7454

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shine Pediatric Dentistry's NPI number?

The NPI number for Shine Pediatric Dentistry is 1104758317. It was assigned to this organization in the NPPES registry on June 1, 2026.

Where is Shine Pediatric Dentistry located?

Shine Pediatric Dentistry is located at 20012 44th Ave, Bayside, NY 11361. The listed phone number is (929) 389-1663.

What is Shine Pediatric Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Shine Pediatric Dentistry was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.