Dr. Shannon Kenneth Moore is a Bloomington, Indiana based Dentist who is specialized in Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Shannon Kenneth Moore is 12010311A for Dentistry in Indiana. His current practice location is 2815 N Walnut Street, Bloomington. Patients can reach him at 812-332-1405.
Dr. Shannon Kenneth Moore is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Shannon Kenneth Moore speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Dr. Shannon Kenneth Moore
Specialization:
Dentist
Gender:
Male
Credentials:
DMD MSED
Accepts Medicare Assignment:
No
Practice Address:
2815 N Walnut Street, Bloomington, Indiana, 47404-2077
Phone:
812-332-1405
Fax:
812-332-4331
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1194855205
NPI Enumeration Date:
07 Mar, 2007
NPI Last Update On:
16 Mar, 2022
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Shannon Kenneth Moore are as mentioned below.
License Number
Specialization
State
Status
12010311A
Dentistry
Indiana
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Shannon Kenneth Moore such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
200326230
Medicaid
Indiana
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
2815 N Walnut Street, Bloomington, Indiana
Zip:
47404-2077
Phone Number:
812-332-1405
Fax Number:
812-332-4331
Patients can reach Dr. Shannon Kenneth Moore at 2815 N Walnut Street, Bloomington, Indiana or can call to book an appointment on 812-332-1405. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.