Shankle Dental-Broken Arrow PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHANKLE DENTAL-BROKEN ARROW PLLC

Practice address

2522 E Kenosha St.
Broken Arrow, OK 74014-6712

Phone

(918) 355-1391

Fax

(918) 355-4135

NPI assigned

Dec 4, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ron Fernandez

Title

Ceo

Phone

(918) 960-3070

Specialties & licenses 1

Addresses

Other names 1

• Dentistry for You Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Keith Shankle, D.D.S.

  • Dentist
  • Muskogee, OK
  • NPI 1578767620
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1265902183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5314 S YALE AVE.",
            "address_2": "SUITE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74135",
            "telephone_number": "918-960-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 E KENOSHA ST.",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146712",
            "telephone_number": "918-355-1391",
            "fax_number": "918-355-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANKLE DENTAL-BROKEN ARROW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-960-3070"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry for You",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serenity'S Baby Spa
• Taroniar Sevathas, DMD
• Narumi Shah, PT
• Terri Ann Shaleen
• Shuhad Shambille, DDS
• Patrick Sharp, D.O.
• Grace Shaw, OTR/L
• Matthew Kent Sheets, DIPL. O.M.
• Alexandra Shellady, DC
• Leah R Shepard

• All providers in Broken Arrow, OK
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.