NPIMap

Organization Active NPI

Daniel Cannon, DDS, Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Tulsa, OK
National Provider Identifier
1437438579
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
158 Issued in IL
Legal business name
DANIEL CANNON, DDS, ORAL AND MAXILLOFACIAL SURGERY
Practice address
4608 S Harvard Ave
Suite C
Tulsa, OK 74135-2913
Phone
(918) 743-1351
Fax
(918) 743-7329
NPI assigned
Aug 8, 2011
Last updated
Aug 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Authorized official

Name
Dr. Daniel Simmonds Cannon, DDSNPI 1013176098
Title
Owner
Phone
(918) 743-1351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 158 IL Primary

Addresses

Primary practice location

4608 S Harvard Ave
Suite C
Tulsa, OK 74135-2913

Mailing address

4608 S Harvard Ave
Suite C
Tulsa, OK 74135-2913
Phone (918) 743-1351

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1437438579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 S HARVARD AVE",
            "address_2": "SUITE C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352913",
            "telephone_number": "918-743-1351",
            "fax_number": "918-743-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 S HARVARD AVE",
            "address_2": "SUITE C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352913",
            "telephone_number": "918-743-1351",
            "fax_number": "918-743-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL CANNON, DDS, ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SIMMONDS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-743-1351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.