Kevin Andrew Shepherd

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

11263 Issued in TN

Practice address

6672 Clinton Hwy Ste 108
Knoxville, TN 37912-1040

Phone

(865) 484-3997

NPI assigned

Apr 3, 2019

Last updated

Mar 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lincoln Memorial University

  dba LMU Dental Clinic

  • General Practice Dentistry
  • Knoxville, TN
  • NPI 1548909294

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1316409717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 COMMONS POINT DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321861",
            "telephone_number": "229-416-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6672 CLINTON HWY STE 108",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379121040",
            "telephone_number": "865-484-3997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Biddle Farms Blvd Ste E-300",
            "address_purpose": "LOCATION",
            "city": "Farragut",
            "state": "TN",
            "postal_code": "379343604",
            "country_code": "US",
            "telephone_number": "865-876-0907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 Saint Mary St",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379174510",
            "country_code": "US",
            "telephone_number": "865-370-2128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "228 Hamilton Crossing Dr",
            "address_purpose": "LOCATION",
            "city": "Alcoa",
            "state": "TN",
            "postal_code": "377012262",
            "country_code": "US",
            "telephone_number": "865-355-7428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7584 Barnett Way",
            "address_purpose": "LOCATION",
            "city": "Powell",
            "state": "TN",
            "postal_code": "378493564",
            "country_code": "US",
            "telephone_number": "865-223-5329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "KEVIN",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "11263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Shepard, M.A
• Derrick Shephard
• Crystal Shepherd, LPN
• Cynthia R. Shepherd, P.T.
• David Jackson Shepherd, PA-C
• Michael Shepherd, B.A.
• Nicole Rose Shepherd, M.A, LPC-MHSP
• Savanna Nye Shepherd, PSYD
• Selma Elise Shepherd, PHARMD
• Terry Preston Shepherd, M.D.

• Periodontics in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Periodontics in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.