Michael Joseph Shannon, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

5277 Issued in LA

Practice address

13360 Coursey Blvd Ste D
Baton Rouge, LA 70816-5024

Phone

(225) 752-1252

Fax

(225) 752-8348

NPI assigned

Jun 26, 2007

Last updated

Aug 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Louisiana State University School of Dentistry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Bird Perkins Cancer CenterGroup PAC ID 4385646280, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary Bird Perkins Cancer Center

  • Clinical Medical Laboratory
  • Baton Rouge, LA
  • NPI 1295833580
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1912103946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13360 COURSEY BLVD STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164970",
            "telephone_number": "225-752-1252",
            "fax_number": "225-752-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13360 COURSEY BLVD STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165024",
            "telephone_number": "225-752-1252",
            "fax_number": "225-752-8348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8585 Picardy Ave",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093748",
            "country_code": "US",
            "telephone_number": "225-387-7000",
            "fax_number": "225-215-1380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4950 Essen Ln",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093738",
            "country_code": "US",
            "telephone_number": "225-767-0847",
            "fax_number": "225-767-1335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "LA",
            "license": "5277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha C. Shamlin, M.D.
• Shane Tewis, DDS of Louisiana, a Professional Dental LLC (Affordable Dentures & Implants - Baton Rouge)
• Shannon Candid Louisiana, Professional Corporation
• Shannon E Smith LPC, LLC
• Amie B Shannon, M.D.
• Omeeka Shannon
• Robin Chatman Shannon, DDS
• Sean Edward Shannon, M.D.
• Stephen Patrick Shannon, DDS
• Daniel Manuel Shapiro, DO

• Prosthodontics in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Prosthodontics in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.