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
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Practice location Address checks out

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

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