DR. SHANNON GREEN DDS
NPI 1811550999
Dentist - Oral and Maxillofacial Surgery in Tulsa, OK

Active since April 15, 2019PECOS EnrolledAccepts Medicare Assignment
4955 S PEORIA AVE, TULSA, OK 74105(918) 895-6568 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 16, 2024, Apr 15, 2019 (2 updates tracked since 2019).

About Dr. Shannon Green Dds NPPES

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

DR. SHANNON GREEN DDS (NPI 1811550999) is an individual oral and maxillofacial surgery provider in Tulsa, Oklahoma, licensed in Oklahoma (247) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and is a graduate of State Un Of Ny, Stony Brook School Of Dental Med (2019).

NPPES Registry Identity

NPI1811550999
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameDR. SHANNON GREENCredential: DDS
Location Address4955 S PEORIA AVETulsa, OK 74105-4629
Mailing Address112 Squire HallBuffalo, NY 14214-8006 · (716) 829-6230 · Fax (716) 829-6230
Sole ProprietorNo
Medical School CMSState Un Of Ny, Stony Brook School Of Dental MedGraduated 2019
Enumeration DateApril 15, 2019
Last NPPES UpdateJuly 16, 20242 updates tracked since enumeration
NPPES CertifiedJuly 16, 2024
NPI 1811550999 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in OK · 247
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
4955 S PEORIA AVE, Tulsa, OK 74105

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Shannon Green Dds is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658608989
PECOS Enrollment IDI20260305000171
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 74105 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.68 – $132.40
Typical copayment $16.62 (range $4.17 – $33.10)
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.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
4955 S PEORIA AVE
TULSA, OK 74105
Dentist
4955 S PEORIA AVE
TULSA, OK 74105
Dentist (General Practice)
4955 S PEORIA AVE
TULSA, OK 74105
Nurse Anesthetist, Certified Registered
4955 S PEORIA AVE
TULSA, OK 74105
Dentist (General Practice)
4955 S PEORIA AVE
TULSA, OK 74105
Dentist
4955 S PEORIA AVE
TULSA, OK 74105
Dentist (General Practice)
4955 S PEORIA AVE
TULSA, OK 74105
Dentist (Orthodontics and Dentofacial Orthopedics)
4955 S PEORIA AVE
TULSA, OK 74105

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 Green's NPI number?

The NPI number for Shannon Green is 1811550999. It was assigned to this individual provider in the NPPES registry on April 15, 2019.

Where is Shannon Green located?

Shannon Green practices at 4955 S Peoria Ave, Tulsa, OK 74105. The listed phone number is (918) 895-6568.

What is Shannon Green's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Shannon Green enrolled in Medicare?

Yes. Shannon Green is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shannon Green accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Shannon Green 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 Green was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.