Active NPI
Michael Shawn Rice, D.M.D., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Paducah, KY
National Provider Identifier
1871711408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 670
- Practice address
- 4710 Village Square Dr
Paducah, KY 42001-7438 - Phone
- (270) 534-1991
- Fax
- (270) 534-1993
- NPI assigned
- Apr 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7417 | KY | |
| Dentist | 122300000X | 019.025255 | IL | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 021.001967 | IL | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 670 | KY | Primary |
Addresses
Primary practice location
4710 Village Square Dr
Paducah, KY 42001-7438
Mailing address
110 Plantation Way
West Paducah, KY 42086-9441
Phone (270) 488-2160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60000544 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.025255 | IL | MD | Dentist |
| 7417 | KY | MD | Dentist |
| 021.001967 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 670 | KY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1871711408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 PLANTATION WAY",
"city": "WEST PADUCAH",
"state": "KY",
"postal_code": "420869441",
"telephone_number": "270-488-2160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4710 VILLAGE SQUARE DR",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420017438",
"telephone_number": "270-534-1991",
"fax_number": "270-534-1993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICE",
"first_name": "MICHAEL",
"middle_name": "SHAWN",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "7417",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.025255",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "021.001967",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "KY",
"license": "670",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60000544",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paducah, KY
- RH Emergency Medicine of Paducah LLC
- RH Hospitalist Medicine of Paducah LLC
- Rheumatology Specialists of Paducah PLLC (Paducah Rheumatology)
- Megan Elizabeth Rhonemus, MD
- Katelyn Elizabeth Rice, ED.S
- Jennifer Richards
- Jessica Ellen Richards, M.S. CCC-SLP
- Lindsey Nicole Richardson
- Sarah Lynn Richardson, APRN
- Savannah Richardson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.