Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Austin James Shackelford, DMD

Individual provider Oral and Maxillofacial Pathology Dentistry · NPI 1558864140

Austin James Shackelford, DMD is an Oral and Maxillofacial Pathology in Wilkes Barre, Pennsylvania. Qualified in 2018, 8 years ago. Practices with Geisinger Clinic, a 3,413-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2018
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone: (570) 808-5626
Fax: (570) 808-6352
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X · Licence DS045082 (PA)

Record details

NPI number1558864140
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedMarch 9, 2018
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL AND MAXILLOFACIAL PATHOLOGY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Geisinger Clinic — 3413 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wilkes Barre