DR. SHANE L MOORE


Address: 2455 W Interstate 40, Amarillo, TX 79109-1852
Phone: 8063505437

DR. SHANE L MOORE (NPI# 1538233622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538233622
Entity Type Individual
Full Name DR. SHANE L MOORE
Credential DDS
Practice Address 2455 W Interstate 40
Amarillo
TX 79109-1852
Practice Telephone 8063505437
Practice Fax Number 8063505438
Mailing Telephone 8063505437
Mailing Fax Number 8063505438
Enumeration Date 2006-11-20
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
18661 TX Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX BLUECROSSBLUE SHIELD 89D745 01
TX UNITED CONCORDIA 1420292 01

Other Providers SHANE MOORE

NPI Name Taxonomy Address Enumeration
1417426529 Shane Moore Nurse Practitioner 7030 New Sanger Ave Ste 204, Waco, TX 76712-4074 2018-11-19
1982224796 Shane Edward Moore Student in an Organized Health Care Education/Training Program 1301 S Crismon Rd, Mesa, AZ 85209-3767 2020-04-22
1518230747 Shane Moore Pharmacist 2155 Lancaster Dr Ne, Salem, OR 97305-1228 2012-02-19
1639333669 Shane D Moore IIi Social Worker 5707 N 22nd St, Tampa, FL 33610-4350 2008-07-18

Office Location

Street Address 2455 W INTERSTATE 40
City AMARILLO
State TX
Zip Code 79109-1852

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750386991 Duane Rosby Tinkler Dentist 2455 W Interstate 40, Amarillo, TX 79109-1852 2005-06-15
1073614772 Amarillo Pediatric Dentistry and Orthodontics, Pa Dentist 2455 W Interstate 40, Amarillo, TX 79109-1852 2006-09-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003455098 Pamela Dawn George Counselor 3807 S. Virginia, Amarillo, TX 79109 2019-12-23
1083251318 Raeann Mask Massage Therapist 3501 W. 45th St, Suite T, Amarillo, TX 79109 2019-12-05
1962044941 Donna Raef Kizziar Nurse Practitioner Bsa Urgent Care Clinic, 4510 Bell St., Amarillo, TX 79109 2019-10-11
1730734971 Suzanne Marie Needham Speech-Language Pathologist 49112 Matador, Amarillo, TX 79109 2019-08-05
1477108686 Danielle Denee' Coleman Pharmacy Technician 5807 Sw 45th Ave, Ste 100, Amarillo, TX 79109 2019-08-05
1245795780 Monica Favela Prieto Nurse Practitioner Bsa Urgent Care Clinc, 4510 Bell St., Amarillo, TX 79109 2019-02-08
1598266439 Catherine Cheyenne Wills Behavior Technician 6031 Bell Street, Amarillo, TX 79109 2018-02-26
1053828038 Anisa Ann Rodriguez-espinoza Behavior Technician 6031 Bell, Amarillo, TX 79109 2017-12-29
1336656313 Johnny Thomas Johansen Behavior Technician 6031 Bell St., Amarillo, TX 79109 2017-12-29
1821535683 Daniel & Max, LLC Optometrist 3501 West I-40, Suite A, Amarillo, TX 79109 2017-01-31
Find all providers in zip 79109

Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356465074 Billy J Metcalf Dentist 4501 Van Winkle, Amarillo, TX 79119-6423 2007-03-19
1255416962 Lorra Lorraine Cantu' Lindsey Dentist 5051 South Soncy, Amarillo, TX 79119 2006-10-25
1679656243 Randall K Browning Dentist 7201 W 34th Ave, Amarillo, TX 79109-3900 2006-10-24
1336255868 Ronald Milton Longanecker Dentist 821 Martin Rd, Amarillo, TX 79107-6813 2006-08-21
1750386991 Duane Rosby Tinkler Dentist 2455 W Interstate 40, Amarillo, TX 79109-1852 2005-06-15
1689677098 William James Kemp Jr. Dentist 2455 I 40 W, Amarillo, TX 79109-1852 2005-05-31
1114407681 Kristin Kae Swanson Dentist 5051 S Soncy Rd, Amarillo, TX 79119-6667 2018-08-15
1497101273 David Harney Dentist 2455 I 40 W, Amarillo, TX 79109-1852 2016-05-10
1063539898 William James Kemp, Jr. Dds, Inc Dentist 821 Martin Rd, Amarillo, TX 79107-6813 2007-03-25
1073614772 Amarillo Pediatric Dentistry and Orthodontics, Pa Dentist 2455 W Interstate 40, Amarillo, TX 79109-1852 2006-09-26
Find all providers in AMARILLO

Competitor

Search similar providers

City AMARILLO
Zip Code 79109

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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