Shannon Allen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.035371 Issued in IL

Practice address

21 Glen Ed Professional Park
Glen Carbon, IL 62034-3333

Phone

(618) 656-0608

NPI assigned

Jul 21, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Troy Dental Associates LLC

  • Dentist
  • Troy, IL
  • NPI 1801758446
  NPD
• Sones Family Dental, LLC

  • Dentist
  • Glen Carbon, IL
  • NPI 1700206406
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1588344824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 PHOENIX CT",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "622256311",
            "telephone_number": "847-345-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GLEN ED PROFESSIONAL PARK",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343333",
            "telephone_number": "618-656-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SHANNON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7789",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.035371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James Samuel Akeman, RBT
• Annette L Albertson
• Timothy L. Allen, L.C.S.W.
• Allergy & Asthma Care LTD
• Joshua C Allison, C-PED
• Alternatives Counseling, Inc
• Alternatives Counseling, Inc.

• Dentist in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.