SOUTHERN ILLINOIS UNIVERSITY CARBONDALE DENTAL SEALANT PROGRAM
NPI 1053582189
Dentist - Dental Public Health in Carbondale, IL

Q: What is Southern Illinois University Carbondale Dental Sealant Program's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dental Public Health, with taxonomy code 1223D0001X.

Active since March 17, 2008

1365 DOUGLAS DR RM 18, CASA, SAH, MC 6615, CARBONDALE, IL 62901(618) 453-7211(618) 453-7020 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Southern Illinois University Carbondale Dental Sealant Program NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN ILLINOIS UNIVERSITY CARBONDALE DENTAL SEALANT PROGRAM (NPI 1053582189) is a healthcare organization registered as a dental public health in Carbondale, Illinois and active in the NPI registry since March 2008. The organization lists Jennifer R Kreid, Dsgp Program Coordinator, as its authorized official.

NPPES Registry Identity

NPI1053582189

Entity TypeOrganization

Primary Taxonomy1223D0001X

Legal Business NameSOUTHERN ILLINOIS UNIVERSITY CARBONDALE DENTAL SEALANT PROGRAM

Location Address1365 DOUGLAS DR RM 18, CASA, SAH, MC 6615Carbondale, IL 62901-2583

Mailing Address1365 Douglas Dr Rm 18, Casa, Sah, Mc 6615Carbondale, IL 62901-2583 · (618) 453-7211 · Fax (618) 453-7020

Phone(618) 453-7211

Fax(618) 453-7020

Organization SubpartYesParent: Southern Illinois University Carbondale

Authorized OfficialJennifer R KreidDsgp Program Coordinator · (618) 453-8823

Enumeration DateMarch 17, 2008

Last NPPES UpdateJune 3, 2025

NPPES CertifiedJune 3, 2025

✔ NPI 1053582189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Dental Public HealthDental Providers

Taxonomy Code1223D0001X

Definition

The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.

Also ListedClinic/Center · DentalTaxonomy 261QD0000X

1365 DOUGLAS DR RM 18, Carbondale, IL 62901

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Other Names 1

Other NameChildrens Healthcare Found Grant

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Illinois University Carbondale Dental Sealant Program's NPI number?

The NPI number for Southern Illinois University Carbondale Dental Sealant Program is 1053582189. It was assigned to this organization in the NPPES registry on March 17, 2008. The provider is also known as Childrens Healthcare Found Grant.

Where is Southern Illinois University Carbondale Dental Sealant Program located?

Southern Illinois University Carbondale Dental Sealant Program is located at 1365 Douglas Dr Rm 18 Casa, Sah, Mc 6615, Carbondale, IL 62901. The listed phone number is (618) 453-7211.

What is Southern Illinois University Carbondale Dental Sealant Program's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dental Public Health, with taxonomy code 1223D0001X.

What insurance does Southern Illinois University Carbondale Dental Sealant Program accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Southern Illinois University Carbondale Dental Sealant Program as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southern Illinois University Carbondale Dental Sealant Program was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.