Shane Allen Mobley, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN24252 Issued in FL

Practice address

450 Turner St Unit 3600
Pensacola, FL 32508-5211

Phone

(904) 483-0689

NPI assigned

Aug 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1306492442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 LODGEPOLE DR",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325839178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 TURNER ST UNIT 3600",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325085211",
            "telephone_number": "904-483-0689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "348 Miracle Strip Pkwy SW Ste 15A",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325485258",
            "country_code": "US",
            "telephone_number": "904-483-0689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "COMMANDING OFFICER,",
            "address_2": "315 MCHUGH BLVD",
            "address_purpose": "LOCATION",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "country_code": "US",
            "telephone_number": "910-451-2208 x203",
            "fax_number": "910-451-8479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "SHANE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MK Advantage Support Services LLC
• MK Counseling, LLC
• Mobile X-Ray Specialists, Inc.
• Dana Leslie Mobley
• Lawrence E Mobley, M.D.
• Michel Steven Moehle, M.D.
• Kamal Mohammad
• Zoya Mohiuddin, MD
• Susan Kay Mohr, P.T.
• Huzefa Moiz, DO

• Dentist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.