Active NPI
Shawna Jade Perry, DMD
- General Practice Dentistry
- Shiloh, IL
National Provider Identifier
1184233934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019032732
- Practice address
- 309 Tamarack LN
Shiloh, IL 62269-2993 - Phone
- (618) 624-7200
- NPI assigned
- Jul 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2020018229 | MO | |
| General Practice Dentistry | 1223G0001X | 019032732 | IL | Primary |
Addresses
Primary practice location
309 Tamarack LN
Shiloh, IL 62269-2993
Mailing address
4424 Vista Ave
Saint Louis, MO 63110-2136
Other practice location 1
500 Fullerton Rd
Swansea, IL 62226-2970
Phone (618) 249-3434
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | sdudovitz.parkplacedental@gmail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019032732 | IL | MD | General Practice Dentistry |
| 2020018229 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760400000000",
"number": "1184233934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4424 VISTA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 TAMARACK LN",
"city": "SHILOH",
"state": "IL",
"postal_code": "622692993",
"telephone_number": "618-624-7200"
}
],
"practiceLocations": [
{
"address_1": "500 Fullerton Rd",
"address_purpose": "LOCATION",
"city": "Swansea",
"state": "IL",
"postal_code": "622262970",
"country_code": "US",
"telephone_number": "618-249-3434",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERRY",
"first_name": "SHAWNA",
"middle_name": "JADE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-28",
"last_updated": "2025-10-14",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2020018229",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019032732",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "sdudovitz.parkplacedental@gmail.com",
"affiliation": "N",
"endpointDescription": "Work Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "309 Tamarack Ln",
"city": "Shiloh",
"state": "IL",
"country_code": "US",
"postal_code": "622692993",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Shiloh, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.