Shine Pediatric Dentistry
Shine Pediatric Dentistry is a healthcare organization registered as Pediatric Dentistry in Bayside, NY, holding Type 2 (organization) NPI 1104758317 since 2026. The authorized official on file is Elliot Shine, Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104758317 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shine Pediatric Dentistry |
| Practice address | 20012 44TH AVE, Bayside, NY, 11361 |
| Phone | 9293891663 |
| Enumeration date | 2026-06-01 |
| Last updated in NPPES | 2026-06-01 |
Authorized official
| Name | Elliot Shine |
|---|---|
| Title | Ceo |
| Phone | 5166950103 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223P0221X | Pediatric Dentistry | Primary | — | — |
Copy-ready billing details
Provider: Shine Pediatric Dentistry NPI: 1104758317 Taxonomy: 1223P0221X (Pediatric Dentistry) Address: 20012 44TH AVE, Bayside, NY, 11361
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1912988254 | James Rand | Individual | Gastroenterology Physician | Bayside, NY |
| 1053520528 | James A Rand MD LLC | Organization | Gastroenterology Physician | Bayside, NY |
Verify this record
Cross-check NPI 1104758317 against the authoritative CMS record: view Shine Pediatric Dentistry on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Where is Shine Pediatric Dentistry located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-06-01.