Oliver D Cannon Jr., 22 YEARS PROF EXPERT

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

NV20201957379 Issued in NV

Practice address

14050 Kyle Canton Rd
Las Vegas, NV 89166

Phone

(702) 301-5705

Fax

(702) 395-5800

NPI assigned

Sep 25, 2026

Last updated

Sep 25, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1508779059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 KYLE CANTON RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89166",
            "telephone_number": "702-301-5705",
            "fax_number": "702-395-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 KYLE CANTON RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89166",
            "telephone_number": "702-301-5705",
            "fax_number": "702-395-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "OLIVER",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "22 YEARS PROF EXPERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "NV20201957379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Cannon
• Kortnie Cannon
• Marissa Cannon, RBT
• Mikayla Cannon
• Nancy Cannon
• Royale Cannon
• Russell Rich Cannon Jr., DMD
• Sakelya Cannon
• Vincent Eric Cannon
• Cosette O Cano Arguelles

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.