Kenneth L. Shackle, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2955 Issued in SC

Practice address

230 Duncan Dr
BLDG. 1440 - Haaf
Savannah, GA 31409-5107

Phone

(912) 315-5417

NPI assigned

Feb 27, 2006

Last updated

May 13, 2015By 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

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1861468191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CHICKADEE RD",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261806",
            "telephone_number": "843-681-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 DUNCAN DR",
            "address_2": "BLDG. 1440 - HAAF",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095107",
            "telephone_number": "912-315-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLE",
        "first_name": "KENNETH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn H. Serpas, LPC, NCC
• Shelby Settle, CCC-SLP
• Ashwin Meyyappan Sevugan, DDS
• Kathryn Blair Sewell, FNP -C
• Jason Eric Seymour, PA-C
• Emily Shadel
• Mehrzad Shafiei, MD
• Laharee Shah, DMD
• Samit Shah, RPH
• Tatsiana Shakhmuts

• General Practice Dentistry in Savannah, GA
• Providers in Savannah, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.