Shady Samuel
Pediatric Dentistry · Mineola, NY
Shady Samuel is a pediatric dentistry with a practice address in Mineola, New York, and NPI 1245536382, issued on Feb 8, 2011. Check the license (New York 055773, as entered in NPPES) with the New York board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Shady Samuel
- Primary taxonomy
- Pediatric Dentistry 1223P0221X
- License number
- 055773 NY
Self-reported in NPPES; status is on the state search - Practice location
- 18 Jerome Ave, Mineola, NY 11501
- Phone
- (718) 268-0452
- Enumerated
- Feb 8, 2011
- Record last updated
- Aug 15, 2017 (not updated in 9 years: call before relying on the address or phone)
- Entity
- Type 1 · individual
8 nearest pediatric dentistry records → All 935 in New York → Look up another NPI →
Verify Shady Samuel in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich New York board licenses this profession
Search for license 055773Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Industry payments in 2024: $49.50
3 payments; by number, the most common kind was food and beverage; the largest payer was Solventum Corporation. The 2,607 providers of this specialty with any payment received $434.77 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Shady Samuel among 935 pediatric dentistry records in New York
Shady Samuel is one of 935 pediatric dentistry records with a practice address in New York. 29% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2011, is newer than 49% of them.
- NPI issued2011 · 49% of these records are older, 47% newer
- In a Medicare fileYes · 29% of these records are
- In the CMS Doctors and Clinicians fileNo · 1% of these records are
- Record last updated2017 · 62% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 1223P0221X and a New York practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Pediatric Dentistry providers in New York
There are 935 pediatric dentistry records in New York.
All 935 in New York → Every provider in Mineola → Pediatric Dentistry nationwide →
The 8 pediatric dentistry records with the nearest ZIP codes
- Kristina Gallo, DDSAlbertson, NY 115071285748731
- Mandy Bauer, DDSCedarhurst, NY 115161811977168
- Joel Preminger, D.M.D.Cedarhurst, NY 115161003044850
- Merav Fruchter, DDSFreeport, NY 115201447385265
- Simranjit Kaur, DDSFreeport, NY 115201881394450
- Divya KheraGarden City, NY 115301407249360
- Elizabeth Kitsos, DDSGarden City, NY 115301164627196
- Henry Maccaro, DDSGarden City, NY 115301679675326
Common questions
What is Shady Samuel's NPI number?
Shady Samuel's National Provider Identifier (NPI) is 1245536382, issued on Feb 8, 2011. An NPI identifies a provider in billing; it is not a license.
Where is Shady Samuel located?
The NPPES record lists a practice address at 18 Jerome Ave, Mineola, NY, 11501. Phone: (718) 268-0452. Providers update this record themselves, so call before visiting.
How can I verify Shady Samuel's license?
NPPES lists New York license number 055773, as entered by the provider. Search the New York board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.