Active NPI
Kyra Jordan Shock, DDS
- Dentist
- Norman, OK
National Provider Identifier
1578357372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 016.0134368
- Practice address
- 4409 Intrepid Cir
Norman, OK 73072-4300 - Phone
- (405) 808-4522
- NPI assigned
- Apr 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14459 | CT | |
| Dentist | 122300000X | 14377 | NC | |
| Dentist | 122300000X | 6001990-15 | WI | |
| Dentist | 122300000X | 18769 | MD | |
| Dentist | 122300000X | 10000721 | MA | |
| Dentist | 122300000X | 016.0134368 | VT | Primary |
| Dentist | 122300000X | 0401419518 | VA |
Addresses
Primary practice location
4409 Intrepid Cir
Norman, OK 73072-4300
Mailing address
4409 Intrepid Cir
Norman, OK 73072-4300
Phone (405) 808-4522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10000721 | MA | MD | Dentist |
| 14377 | NC | MD | Dentist |
| 0401419518 | VA | MD | Dentist |
| 016.0134368 | VT | MD | Dentist |
| 18769 | MD | MD | Pharmacist |
| 14459 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1578357372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4409 INTREPID CIR",
"city": "NORMAN",
"state": "OK",
"postal_code": "730724300",
"telephone_number": "405-808-4522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4409 INTREPID CIR",
"city": "NORMAN",
"state": "OK",
"postal_code": "730724300",
"telephone_number": "405-808-4522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOCK",
"first_name": "KYRA",
"middle_name": "JORDAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-07",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "14459",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "14377",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6001990-15",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "18769",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "10000721",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VT",
"license": "016.0134368",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401419518",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.