Kenneth Keith Shankle, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

5961 Issued in OK

Practice address

2406 E Shawnee Rd
Suite D
Muskogee, OK 74403-1597

Phone

(918) 682-5518

Fax

(918) 683-0410

NPI assigned

Jun 13, 2007

Last updated

Dec 4, 2018By 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)

Enrolled

State licenses

Practice roles

Locations

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.

• Shankle Dental-Broken Arrow PLLC

  dba Dentistry for You

  • General Practice Dentistry
  • Broken Arrow, OK
  • NPI 1265902183
  NPD
• Mark R Doherty DDS PC

  • Dental Clinic/Center
  • Pryor, OK
  • NPI 1285147694

  Dentist

  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1578767620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 E SHAWNEE RD",
            "address_2": "SUITE D",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031597",
            "telephone_number": "918-682-5518",
            "fax_number": "918-683-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 E SHAWNEE RD",
            "address_2": "SUITE D",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031597",
            "telephone_number": "918-682-5518",
            "fax_number": "918-683-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 S Elliott St",
            "address_purpose": "LOCATION",
            "city": "Pryor",
            "state": "OK",
            "postal_code": "743618027",
            "country_code": "US",
            "telephone_number": "918-825-0941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2522 E Kenosha St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740146712",
            "country_code": "US",
            "telephone_number": "918-355-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKLE",
        "first_name": "KENNETH",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Sequera
• Tracy Ann Settlemyre
• Brittni Settles
• Julia Sewell
• Lacee J Shade, RN
• Keeley Sharp
• Victor Sharp Jr.
• B Frank Shaw, DO
• Ronda Shaw, RN
• Sheltered Work Activity Program (Incor)

• Dentist in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.