Southern Illinois University Carbondale Dental Sealant Program
NPI 1053582189 · Public Health Dentistry · Carbondale, IL
Southern Illinois University Carbondale Dental Sealant Program is a Public Health Dentistry organization in Carbondale, IL (NPI 1053582189).
Provider details
- NPI number
- 1053582189
- Entity type
- Organization
- Primary specialty
- Public Health DentistryDental Providers
- Parent organization
- Southern Illinois University Carbondale
- Organization subpart
- Yes
- Authorized official
- Jennifer Kreid, Dsgp Program Coordinator(618) 453-8823
Specialties & taxonomies
Dental Providers
- Dental Clinic/Center261QD0000X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Childrens Healthcare Found Grant
Registry dates
- Enumerated
- 2008-03-17
- Last updated
- 2025-06-03
- Certified
- 2025-06-03
Frequently asked questions
- What is Southern Illinois University Carbondale Dental Sealant Program's NPI number?
- Southern Illinois University Carbondale Dental Sealant Program's National Provider Identifier (NPI) is 1053582189, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Illinois University Carbondale Dental Sealant Program?
- Southern Illinois University Carbondale Dental Sealant Program is classified in the NPPES registry as Public Health Dentistry (Dental Providers).
- Where is Southern Illinois University Carbondale Dental Sealant Program located?
- Southern Illinois University Carbondale Dental Sealant Program's practice location on file with NPPES is 1365 Douglas Dr Rm 18, Carbondale, IL 62901-2583.
- What is Southern Illinois University Carbondale Dental Sealant Program's phone number?
- The practice phone number listed in the NPPES registry for Southern Illinois University Carbondale Dental Sealant Program is (618) 453-7211.
- Who is the authorized official for Southern Illinois University Carbondale Dental Sealant Program?
- The authorized official listed on Southern Illinois University Carbondale Dental Sealant Program's NPPES record is Jennifer Kreid, Dsgp Program Coordinator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Illinois University Carbondale Dental Sealant Program's NPI active?
- Yes — Southern Illinois University Carbondale Dental Sealant Program's NPI (1053582189) is active in the NPPES registry as of the last update on 2025-06-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.