Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shawnee Health Service & Development Corp

Organization Dentist · NPI 1174859870

Shawnee Health Service & Development Corp is a Dentist in Carbondale, Illinois. Licensed in Illinois. Registered with an NPI since 2009.

Licensed in
IL
In the registry since
2009
Specialties on file
5
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

402 S Lewis Ln
Carbondale, IL 62901
Phone: (618) 519-9901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Dentist Taxonomy 122300000X (IL)
Pediatric Dentistry Taxonomy 1223P0221X (IL)
Dental Hygienist Taxonomy 124Q00000X (IL)
Dental Assistant Taxonomy 126800000X (IL)

Record details

NPI number1174859870
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationShawnee Health Service and Development Corp
Authorized official Christina Carney — Ceo · (618) 956-9521
Other names Shawnee Health Care, Carbondale Dental
NPI enumeratedOctober 30, 2009
Last updated in NPPESApril 4, 2024
Certification dateApril 4, 2024
Mailing address109 California St, Po Box 577, Carterville, IL 62918-1923

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