Glen Shanock'S Dentistry, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

045836 Issued in NY

Legal business name

GLEN SHANOCK'S DENTISTRY, PC

Practice address

120 W Park Ave
Suite 301
Long Beach, NY 11561-3301

Phone

(516) 431-5855

Fax

(516) 431-0728

NPI assigned

Feb 21, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Glen Shanock, DDSNPI 1871578377

Title

Owner

Phone

(516) 431-5855

Specialties & licenses 1

Addresses

Other names 1

• Dr. Glen's Happy Teeth Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glen Shanock, DDS

  • Pediatric Dentistry
  • Long Beach, NY
  • NPI 1871578377
  NPD (past) Authorized official
• Fernanda Carla Mendoza Cervantes, DDS

  • Pediatric Dentistry
  • Newark, NJ
  • NPI 1487385423
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1730628884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W PARK AVE",
            "address_2": "SUITE 301",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613301",
            "telephone_number": "516-431-5855",
            "fax_number": "516-431-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W PARK AVE",
            "address_2": "SUITE 301",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613301",
            "telephone_number": "516-431-5855",
            "fax_number": "516-431-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN SHANOCK'S DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "SHANOCK",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-431-5855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "045836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Glen's Happy Teeth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bruce Jeffrey Gitt, D.M.D.
• Jenna Kaye Glaser, M.S. CCC-SLP
• Glass and Pomerantz, MD'S, PLLC
• Shiran Glass, LCSW
• Glasshouse Applied Behavior Analysis PLLC
• Laura Eileen Glenz, RD
• Andrew M. Goldberg, D.D.S.
• Linda Ruth Goldstein, NURSE PRACTITIONER
• Cary Miles Golub, D.P.M.
• Giannina Gomez

• Pediatric Dentistry in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.