Provider Demographics
NPI:1205866712
Name:RICE, JERRI L (DDS)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:L
Last Name:RICE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 W 83RD ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5120
Mailing Address - Country:US
Mailing Address - Phone:913-341-8900
Mailing Address - Fax:
Practice Address - Street 1:3700 W 83RD ST
Practice Address - Street 2:SUITE 110
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5120
Practice Address - Country:US
Practice Address - Phone:913-341-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice