Todd David Shockley, DMD is a medicare enrolled "Dentist - General Practice" provider in Keystone Heights, Florida. His current practice location is
260 S Lawrence Blvd, Suite 102, Keystone Heights, Florida. You can reach out to his office (for appointments etc.) via phone at
(352) 473-0707.
Todd David Shockley is licensed to practice in Florida (license number DN15741) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1194919779.
Healthcare Provider's Profile
Full Name | Todd David Shockley |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 260 S Lawrence Blvd, Keystone Heights, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1194919779
- Provider Enumeration Date: 08/28/2007
- Last Update Date: 08/28/2007
Medicare PECOS Information:
- PECOS PAC ID: 4981901998
- Enrollment ID: I20160317002328
Medical Identifiers
Medical identifiers for Todd David Shockley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194919779 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | DN15741 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Todd David Shockley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Todd David Shockley, DMD 260 S Lawrence Blvd, Suite 102, Keystone Heights, FL 32656-9217 Ph: (352) 473-0707 | Todd David Shockley, DMD 260 S Lawrence Blvd, Suite 102, Keystone Heights, FL 32656-9217 Ph: (352) 473-0707 |
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