Jack A. Shannon, DDS

Dentist · Taft, OK

Individual Active NPI

NPI number 1366746117

Practice location

601 S 124TH St. West
Taft, OK 74463
Phone
(918) 682-7841
Fax
(918) 682-6107

Open in Google Maps

NPI record

NPI
1366746117
Entity type
Individual (Type 1)
Enumeration date
January 7, 2011
Last updated
January 7, 2011
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 5531 OK

Mailing address

9807 S 225TH East Ave
Broken Arrow, OK 74014-5928
Phone
(918) 519-5751

About Dr. Shannon

Jack A. Shannon, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 601 S 124TH St. West, Taft, OK 74463. The NPI number 1366746117 was assigned on January 7, 2011 and the record was last updated on January 7, 2011.

Dr. Shannon lists a license in the registry: #5531 (OK) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jack A. Shannon, DDS?

The NPI number is 1366746117.

What is the phone number of Dr. Shannon?

The phone number listed for the practice location is (918) 682-7841.

Where is Dr. Shannon located?

601 S 124TH St. West, Taft, OK 74463.

What is the taxonomy code for Dr. Shannon?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.