Glen Shanock, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

045836 Issued in NY

Practice address

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

Phone

(516) 431-5855

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: gshanock682604@nychhc.direct-ci.com
• Direct secure messaging: gshanock307834@nyumc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glen Shanock'S Dentistry, PC

  • Pediatric Dentistry
  • Long Beach, NY
  • NPI 1730628884
  NPD (past) Authorized official

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871578377",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANOCK",
        "first_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "045836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senior'S Alternative Physical Therapy PC
• Yvonne Ann Shafranek, MS.ED
• Ruchir Shah, MS OTR/L
• Shefali I. Shah, M.D.
• Avivit Shalom
• Syeda Sharieff
• Jacqueline Sharkey
• Alyssa Anne Sharma, DPT
• Lawrence W Shields, M.D.
• Jared Muskin Shiff, PSY.D.

• 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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.