DR. SAMUEL L SHACKELFORD DDSPC
NPI 1609946441
Dentist in Lawrenceburg, TN

Q: What is Samuel Shackelford's NPI number?

The NPI number for Samuel Shackelford is 1609946441. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Q: What is Samuel Shackelford's specialty?

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

Q: Is Samuel Shackelford enrolled in Medicare?

No. Samuel Shackelford has opted out of Medicare through May 26, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since November 09, 2006Opted out of Medicare · through May 26, 2028

336 ROBBINS ST, LAWRENCEBURG, TN 38464(931) 762-2894(931) 762-2894 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Samuel L Shackelford Ddspc NPPES

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

DR. SAMUEL L SHACKELFORD DDSPC (NPI 1609946441) is an individual dentist in Lawrenceburg, Tennessee, licensed in Tennessee (DS3400) and active in the NPI registry since November 2006. He has opted out of Medicare through May 26, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609946441

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. SAMUEL L SHACKELFORDCredential: DDSPC

Location Address336 ROBBINS STLawrenceburg, TN 38464

Mailing Address336 Robbins StLawrenceburg, TN 38464 · (931) 762-2894 · Fax (931) 762-2894

Phone(931) 762-2894

Fax(931) 762-2894

Sole ProprietorNo

Enumeration DateNovember 9, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1609946441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in TN · DS3400

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.

336 ROBBINS ST, Lawrenceburg, TN 38464

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Other Identifiers 1

Medicare UPINI74251

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Samuel L Shackelford Ddspc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 26, 2016 through May 26, 2028.

Opt-Out Effective DateMay 26, 2016

Opt-Out In Effect ThroughMay 26, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38464 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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 Samuel Shackelford's NPI number?

The NPI number for Samuel Shackelford is 1609946441. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Where is Samuel Shackelford located?

Samuel Shackelford practices at 336 Robbins St, Lawrenceburg, TN 38464. The listed phone number is (931) 762-2894.

What is Samuel Shackelford's specialty?

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

Is Samuel Shackelford enrolled in Medicare?

No. Samuel Shackelford has opted out of Medicare through May 26, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Samuel Shackelford was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.