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SHADY SAMUEL
NPI 1245536382
Dentist - Pediatric Dentistry in Mineola, NY

Active since February 08, 2011
18 JEROME AVE, MINEOLA, NY 11501(718) 268-0452 Get Directions Write a Review

NPPES record last updated: August 15, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shady Samuel NPPES

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

SHADY SAMUEL (NPI 1245536382) is an individual pediatric dentistry provider in Mineola, New York, licensed in New York (055773) and active in the NPI registry since February 2011.

NPPES Registry Identity

NPI1245536382
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameSHADY SAMUEL
Location Address18 JEROME AVEMineola, NY 11501-3302
Mailing Address18 Jerome AveMineola, NY 11501-3302
Phone(718) 268-0452
Sole ProprietorYes
Enumeration DateFebruary 8, 2011
Last NPPES UpdateAugust 15, 2017
✔ NPI 1245536382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in NY · 055773
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.

18 JEROME AVE, Mineola, NY 11501
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

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 Shady Samuel's NPI number?

The NPI number for Shady Samuel is 1245536382. It was assigned to this individual provider in the NPPES registry on February 8, 2011.

Where is Shady Samuel located?

Shady Samuel practices at 18 Jerome Ave, Mineola, NY 11501. The listed phone number is (718) 268-0452.

What is Shady Samuel's specialty?

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

What insurance does Shady Samuel accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Shady Samuel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shady Samuel was last updated on August 15, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.