Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1376160010 Individual Practitioner Male Practitioner

Dr. Shane Robert Mctiernan , DMD

Dentist - General Practice • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Shane Mctiernan, DMD is a registered healthcare professional specializing in Dentist - General Practice in Jacksonville, FL. Practice services are available at 651 NAUTICA DR UNIT 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

651 Nautica Dr Unit 1

Jacksonville, FL 322187222

Telephone 9044234014
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
363 Specialists

Practicing in Jacksonville, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-01-15
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN25009

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License OK 7968

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
NPI 1104207554

Doctor of Dental Medicine

Dr. Vanessa Blanco , DMD

Dentist - General Practice

NPI 1497698708

Doctor of Dental Medicine

NPI 1578350807

Doctor of Dental Medicine

Dr. Gregory Sabino , DDS, PhD

Dentist - General Practice

NPI 1598112229

Doctor of Dental Surgery, Doctor of Philosophy (Ph.D.)

Dr. Manuel Acosta Hernandez , DDS

Dentist - General Practice

NPI 1619523560

Doctor of Dental Surgery

NPI 1649893595

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location January 15, 2025

Registered at 651 NAUTICA DR UNIT 1, JACKSONVILLE, FL 322187222 (Tel: 9044234014)

📍
Updated Business Mailing Address January 15, 2025

Registered at 10020 INVENTION LN, JACKSONVILLE, FL 322564093 (Tel: 5706870798)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 15, 2025

Dentist (License #7968 in OK)

📍
Updated Practice Location October 10, 2024

Registered at 6400 SW 3RD ST STE B, OKLAHOMA CITY, OK 731282209 (Tel: 4054162357)

📍
Updated Business Mailing Address October 10, 2024

Registered at 3301 COMMONS CT, EDMOND, OK 730346158 (Tel: 5706870798)

NPI Profile Active June 29, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location June 29, 2020

Registered at 463859 STATE ROAD 200, YULEE, FL 320973639 (Tel: 9043353222)

📍
Updated Business Mailing Address June 29, 2020

Registered at 1242 N 16TH ST APT 1, PHILADELPHIA, PA 191215006 (Tel: 5706870798)

👤
Provider Name / Credentials Updated June 29, 2020

Recorded as SHANE MCTIERNAN, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2020

Dentist (License #DN25009 in FL)

🟢
Initial NPI Registration & Enumeration June 29, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376160010
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 29, 2020
Last Update: January 15, 2025
Sole Proprietor: No

Mailing Address

10020 Invention Ln

Jacksonville, FL 322564093

Phone: 5706870798

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.