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DR. SHANNON KENNETH MOORE DMD MSED
NPI 1194855205
Dentist in Bloomington, IN

Active since March 07, 2007
2815 N WALNUT STREET, BLOOMINGTON, IN 47404(812) 332-1405(812) 332-4331 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Shannon Kenneth Moore Dmd Msed NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANNON KENNETH MOORE DMD MSED (NPI 1194855205) is an individual dentist in Bloomington, Indiana, licensed in Indiana (12010311A) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1194855205
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. SHANNON KENNETH MOORECredential: DMD MSED
Location Address2815 N WALNUT STREETBloomington, IN 47404-2077
Mailing Address2815 N Walnut StreetBloomington, IN 47404-2077 · (812) 332-1405 · Fax (812) 332-4331
Phone(812) 332-1405
Fax(812) 332-4331
Sole ProprietorNo
Enumeration DateMarch 7, 2007
Last NPPES UpdateMarch 16, 2022
NPPES CertifiedMarch 16, 2022
✔ NPI 1194855205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IN · 12010311A
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
2815 N WALNUT STREET, Bloomington, IN 47404
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Other Identifiers 1

Medicaid200326230IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Moore's NPI number?

The NPI number for Shannon Moore is 1194855205. It was assigned to this individual provider in the NPPES registry on March 7, 2007.

Where is Shannon Moore located?

Shannon Moore practices at 2815 N Walnut Street, Bloomington, IN 47404. The listed phone number is (812) 332-1405.

What is Shannon Moore's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Shannon Moore accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, BEST Life and Blue Cross and Blue Shield of Montana and 12 other insurers list Shannon Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Moore was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.