Healthcare Provider Details

I. General information

NPI: 1780549899
Provider Name (Legal Business Name): SHEN SMILES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 KISSENA BLVD STE 111
FLUSHING NY
11355-2950
US

IV. Provider business mailing address

4343 KISSENA BLVD STE 111
FLUSHING NY
11355-2950
US

V. Phone/Fax

Practice location:
  • Phone: 347-368-6777
  • Fax: 347-368-6816
Mailing address:
  • Phone: 347-368-6777
  • Fax: 347-368-6816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA L SHEN
Title or Position: OWNER-DENTIST
Credential: DDS
Phone: 570-956-9962