Healthcare Provider Details

I. General information

NPI: 1598632168
Provider Name (Legal Business Name): SHI ELSHAROUNY DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 OLD COUNTRY RD STE 105
GARDEN CITY NY
11530-1701
US

IV. Provider business mailing address

350 OLD COUNTRY RD STE 105
GARDEN CITY NY
11530-1701
US

V. Phone/Fax

Practice location:
  • Phone: 516-276-0308
  • Fax: 516-276-0510
Mailing address:
  • Phone: 516-276-0308
  • Fax: 516-276-0510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SI C SHI-ELSHAROUNY
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 516-276-0308