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

Dr. Shannon Green, DDS

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1811550999

Dr. Shannon Green, DDS is an Oral Surgery in Tulsa, Oklahoma. Graduated from State Un of Ny, Stony Brook School of Dental Med in 2019, 7 years ago. Practices with St Lukes Physician Group Inc, a 2,127-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
7
Trained at
State Un of Ny, Stony Brook School of Dental Med
Licensed in
OK
In the registry since
2019
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

4955 S Peoria Ave
Tulsa, OK 74105-4629
Phone: (918) 895-6568
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 247 (OK)

Record details

NPI number1811550999
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 15, 2019
Last updated in NPPESJuly 16, 2024
Certification dateJuly 16, 2024
Mailing address112 Squire Hall, Buffalo, NY 14214-8006

Medicare enrollment

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

Medicare specialtyORAL SURGERY
Also practisesMAXILLOFACIAL SURGERY
Medical schoolSTATE UN OF NY, STONY BROOK SCHOOL OF DENTAL MED
Graduated 2019 (7 years in practice)
Group practice St Lukes Physician Group Inc — 2127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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