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DR. KEVIN JAY SHIVELY JR. DMD
NPI 1588096390
Dentist in Lubbock, TX

Active since August 02, 2013PECOS Enrolled
12219 QUAKER AVE STE A, LUBBOCK, TX 79424(806) 698-8660(806) 319-3878 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2021, Feb 15, 2019 (2 updates tracked since 2019).

About Dr. Kevin Jay Shively Jr. Dmd NPPES

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

DR. KEVIN JAY SHIVELY JR. DMD (NPI 1588096390) is an individual dentist in Lubbock, Texas, licensed in Texas (34543) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Apo.

NPPES Registry Identity

NPI1588096390
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. KEVIN JAY SHIVELY JR.Credential: DMD
Location Address12219 QUAKER AVE STE ALubbock, TX 79424-7783
Mailing Address12219 Quaker Ave Ste ALubbock, TX 79424-7783 · (806) 698-8660 · Fax (806) 319-3878
Phone(806) 698-8660
Fax(806) 319-3878
Sole ProprietorNo
Enumeration DateAugust 2, 2013
Last NPPES UpdateMarch 17, 20212 updates tracked since enumeration
NPPES CertifiedMarch 17, 2021
✔ NPI 1588096390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in TX · 34543
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.
12219 QUAKER AVE STE A, Lubbock, TX 79424
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Secondary Practice Location 1

Location 1Unit 28038, USA Dentac BavariaAPO, AE 09112 · Phone 011499622834738

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Jay Shively Jr. Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79424 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kevin Shively's NPI number?

The NPI number for Kevin Shively is 1588096390. It was assigned to this individual provider in the NPPES registry on August 2, 2013.

Where is Kevin Shively located?

Kevin Shively practices at 12219 Quaker Ave Ste A, Lubbock, TX 79424. The listed phone number is (806) 698-8660.

What is Kevin Shively's specialty?

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

Is Kevin Shively enrolled in Medicare?

Yes. Kevin Shively is registered in the Medicare PECOS enrollment system.

What insurance does Kevin Shively accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 2 other insurers list Kevin Shively 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 Kevin Shively was last updated on March 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.