Samuel Lee Donavon is a Glen Carbon, Illinois based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Samuel Lee Donavon is
01903713 for Dentistry in Illinois. His current practice location is
21 Glen Ed Professional Park, Glen Carbon. Patients can reach him at
618-656-0608.
Samuel Lee Donavon is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Samuel Lee Donavon speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Samuel Lee Donavon |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 21 Glen Ed Professional Park, Glen Carbon,
Illinois, 62034-3333 |
| Phone: | 618-656-0608 |
| Fax: | 618-656-0615 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1164357737 |
| NPI Enumeration Date: | 16 Jun, 2026 |
| NPI Last Update On: | 16 Jun, 2026 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Samuel Lee Donavon are as mentioned below.
| License Number | Specialization | State | Status | |
| 01903713 | Dentistry | Illinois | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Samuel Lee Donavon such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 019037193 | Other | Illinois | GENERAL DENTIST |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 21 Glen Ed Professional Park,
Glen Carbon, Illinois |
| Zip: | 62034-3333 |
| Phone Number: | 618-656-0608 |
| Fax Number: | 618-656-0615 |
Patients can reach Samuel Lee Donavon at
21 Glen Ed Professional Park, Glen Carbon, Illinois or can
call to book an appointment on 618-656-0608.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
13 July, 2026.