DR. GLEN SHANOCK DDS NPI 1871578377

NPI Information

  • NPI: 1871578377
  • Provider Name: DR. GLEN SHANOCK, DDS
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 120 W PARK AVE
    SUITE 301
    LONG BEACH, NY
    ZIP 11561
  • Phone: (516) 431-5855

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NPI Details

DR. Glen Shanock, DDS is a pediatric dentistry dentist in Long Beach, NY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Glen Shanock, DDS NPI is 1871578377. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

120 W PARK AVE
SUITE 301
LONG BEACH, NY
ZIP 11561-301
Phone: (516) 431-5855

The NPI 1871578377 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 12/7/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry045836NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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