Thompson, Rickey Shane
Thompson, Rickey Shane is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 67420. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Thompson, Rickey Shane can be contacted via phone (505) 368-6401.Contact Information
Primary practice address
Us Hwy 491 North
Shiprock NM 67420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 15951 | Texas |
Profile Details
| NPI number | 1184613945 |
|---|---|
| LBN Legal business name | Thompson, Rickey Shane |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Sep 20th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184613945 | NPPES |
| Colorado | MEDICAID | 02159515 | |
| Colorado | MEDICAID | 689896 | |
| Colorado | MEDICAID | 31847820 |
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