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

Samuel Lee Donavon, DMD

Individual provider Dentist · NPI 1164357737

Samuel Lee Donavon, DMD is a Dentist in Glen Carbon, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2026
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

21 Glen ED Professional Park
Glen Carbon, IL 62034-3333
Phone: (618) 656-0608
Fax: (618) 656-0615
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 01903713 (IL)

Record details

NPI number1164357737
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedJune 16, 2026
Last updated in NPPESJune 16, 2026
Certification dateJune 16, 2026
Mailing address21 Glen Ed Professional Park, Glen Carbon, IL 62034-3333

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