Dr Jack A Shannon, DDS is a
Dentist based in Taft, Oklahoma. Dr Jack A Shannon is licensed to practice in Oklahoma (license number 5531) and his current practice location is
601 S 124th St. West, Taft, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(918) 682-7841.
NPI number for Dr Jack A Shannon is 1366746117 and his current mailing address is 9807 S 225th East Ave, Broken Arrow, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1366746117.
Healthcare Provider's Profile
| Full Name | Dr Jack A Shannon |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
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| Location | 601 S 124th St. West, Taft, Oklahoma |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1366746117
- Provider Enumeration Date: 01/07/2011
- Last Update Date: 01/07/2011
Medical Identifiers
Medical identifiers for Dr Jack A Shannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366746117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 5531 (Oklahoma) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack A Shannon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack A Shannon, DDS
9807 S 225th East Ave,
Broken Arrow, OK 74014-5928
Ph: (918) 519-5751 | Dr Jack A Shannon, DDS
601 S 124th St. West,
Taft, OK 74463
Ph: (918) 682-7841 |
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