Organization · Type 2 NPI

Shawnee Health Service and Development Corp

Pediatric Dentistry · Marion, IL

NPI number 1164385753 Active

Practice location

3115 Williamson County Pkwy Ste B
Marion, IL 62959-5287

Call (618) 519-9200 Map

Mailing address

109 California St
Carterville, IL 62918-1923

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	None listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Other pediatric dentistry providers in Marion

Martha Jo Braid DMD LLCPediatric Dentistry Marion, IL NPI 1669621140

See all in Marion →

NPI record

NPI: 1164385753
Entity type: Organization (Type 2)
Issued: Dec 9, 2025
Last updated: Dec 9, 2025
Status: Active
Subpart: Yes of Shawnee Health Service and Development Corp

Other names

Shawnee Health, Children's Dental Center - Advanced Care · doing business as

Authorized official

Christina Carney
CEO
(618) 985-8221

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1164385753

Shawnee Health Service and Development Corp's National Provider Identifier is 1164385753, issued on Dec 9, 2025. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Marion, IL. The record was last updated on Dec 9, 2025.