Shady Samuel is a Mineola, New York based Pediatric Dentist who is specialized in
Pediatric Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Shady Samuel is
055773 for Pediatric Dentistry in New York. His current practice location is
18 Jerome Ave, Mineola. Patients can reach him at
718-268-0452.
Shady Samuel provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Profile:
Shady Samuel speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Shady Samuel |
| Specialization: | Pediatric Dentist |
| Gender: | Male |
| Accepts Medicare Assignment: | No |
| Practice Address: | 18 Jerome Ave, Mineola,
New York, 11501-3302 |
| Phone: | 718-268-0452 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1245536382 |
| NPI Enumeration Date: | 08 Feb, 2011 |
| NPI Last Update On: | 15 Aug, 2017 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Shady Samuel are as mentioned below.
| License Number | Specialization | State | Status | |
| 055773 | Pediatric Dentistry | New York | Primary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 18 Jerome Ave,
Mineola, New York |
| Zip: | 11501-3302 |
Patients can reach Shady Samuel at
18 Jerome Ave, Mineola, New York or can
call to book an appointment on 718-268-0452.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.