Healthcare Provider Details

I. General information

NPI: 1336018183
Provider Name (Legal Business Name): TRU SMILES DENTAL OF HUNTINGTON PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E MAIN ST STE 1-1
HUNTINGTON NY
11743-7934
US

IV. Provider business mailing address

205 E MAIN ST STE 1-1
HUNTINGTON NY
11743-7934
US

V. Phone/Fax

Practice location:
  • Phone: 631-421-1818
  • Fax:
Mailing address:
  • Phone: 631-421-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: RADMILA SHUMINOV
Title or Position: OWNER
Credential:
Phone: 631-421-1818