Organization
SHINING DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILY YE (OWNER)
(718) 808-9898
Entity
Organization
Contact information
Practice address
14238 37TH AVE UNIT 1F, FLUSHING, NY 11354-4569
(347) 699-8868
Mailing address
14238 37TH AVE UNIT 1F, FLUSHING, NY 11354-4569
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03422497
—
NY
Enumeration date
03/29/2019
Last updated
01/29/2023
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