Active NPI
Shawn Allen May, DDS
- Dentist
- Fairview Heights, IL
National Provider Identifier
1760571103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019027153
- Practice address
- 6407 N Illinois St
Fairview Heights, IL 62208-2720 - Phone
- (618) 310-0263
- Fax
- (618) 212-9054
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019027153 | IL | Primary |
| General Practice Dentistry | 1223G0001X | 2018028936 | MO |
Addresses
Primary practice location
6407 N Illinois St
Fairview Heights, IL 62208-2720
Mailing address
209 Williamsburg Dr
Crystal City, MO 63019-1271
Phone (217) 450-7535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160919000873 | IL | Order and Referring Only - Other (Non-Physician) | 1456648526 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019027153 | IL | MD | Dentist |
| 2018028936 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robinson Smile Center LLC | General Practice | Past | Accepting new patients |
| J. Warren Hildreth, Jr DDS PC of Missouri | General Practice | Past | Accepting new patients |
| Jason Luchtefeld, DMD, LLC | General Practice | Past | Accepting new patients |
| Mid - America Hearing Center, Inc | Past | Accepting new patients | |
| Fairview Heights Dentistry, PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 5
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.
-
dba Fairview Heights Dentistry
- Dentist
- Fairview Heights, IL
- NPI 1811558208
-
- General Practice Dentistry
- Robinson, IL
- NPI 1942577002
-
- General Practice Dentistry
- Robinson, IL
- NPI 1720669831
-
- General Practice Dentistry
- Mount Vernon, MO
- NPI 1952403040
-
- Hearing Instrument Specialist
- Mount Vernon, MO
- NPI 1578665550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1760571103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 WILLIAMSBURG DR",
"city": "CRYSTAL CITY",
"state": "MO",
"postal_code": "630191271",
"telephone_number": "217-450-7535",
"fax_number": "618-212-9054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6407 N ILLINOIS ST",
"city": "FAIRVIEW HEIGHTS",
"state": "IL",
"postal_code": "622082720",
"telephone_number": "618-310-0263",
"fax_number": "618-212-9054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAY",
"first_name": "SHAWN",
"middle_name": "ALLEN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2022-06-02",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019027153",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2018028936",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairview Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.