IndividualActive
David Dunivan, D.M.D.,M.S.
NPI 1306911003 · Periodontics · Edwardsville, IL
Provider details
- NPI number
- 1306911003
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- D.M.D.,M.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 021-002115 (IL)
Specialties & taxonomies
Dental Providers
Practice location
1120 S State Route 157 Ste 102
Edwardsville, IL 62025-3614
Phone: (618) 655-1580
Fax: (618) 655-1581
Approximate (ZIP-level) locationGet directions
Mailing address
1120 S State Route 157 Ste 102
Edwardsville, IL 62025-3614
Registry dates
- Enumerated
- 2006-11-21
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.