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DR. KATHERINE MAE SHADID DMD
NPI 1144066747
Dentist in Peoria, IL

Active since July 02, 2024
843 W GLEN AVE, PEORIA, IL 61614(309) 691-9421 Get Directions Write a Review

NPPES record last updated: July 2, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Katherine Mae Shadid Dmd NPPES

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

DR. KATHERINE MAE SHADID DMD (NPI 1144066747) is an individual dentist in Peoria, Illinois, licensed in Illinois (019.035294) and active in the NPI registry since July 2024. She maintains a secondary practice location in Peoria.

NPPES Registry Identity

NPI1144066747
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. KATHERINE MAE SHADIDCredential: DMD
Location Address843 W GLEN AVEPeoria, IL 61614-4834
Mailing Address11120 N Brookhaven CtPeoria, IL 61615-1009
Phone(309) 691-9421
Sole ProprietorNo
Enumeration DateJuly 2, 2024
NPPES CertifiedJuly 2, 2024
✔ NPI 1144066747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019.035294
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
843 W GLEN AVE, Peoria, IL 61614
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Secondary Practice Location 1

Location 17314 N Willow Lake Ct Ste DPeoria, IL 61614-8289 · Phone (309) 692-0175

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICOLE MARIE SUDHOLT D.M.D.
Dentist
843 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 691-9421
DONLAN DENTAL GROUP
Dentist (General Practice)
843 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 691-9421

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 Katherine Shadid's NPI number?

The NPI number for Katherine Shadid is 1144066747. It was assigned to this individual provider in the NPPES registry on July 2, 2024.

Where is Katherine Shadid located?

Katherine Shadid practices at 843 W Glen Ave, Peoria, IL 61614. The listed phone number is (309) 691-9421.

What is Katherine Shadid's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Katherine Shadid was last updated on July 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.