RDG William Cannon, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RDG WILLIAM CANNON, PLLC

Doing business as

Rose Dental Group William Cannon

Practice address

6211 W William Cannon Dr
Austin, TX 78749-1923

Phone

(737) 260-3888

NPI assigned

Aug 17, 2022

Last updated

Dec 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Lightfoot

Title

Authorized Representative

Phone

(214) 702-0708

Specialties & licenses 1

Addresses

Other names 1

• Rose Dental Group William Cannon Doing business as

Locations

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1720706682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 W WILLIAM CANNON DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491923",
            "telephone_number": "737-260-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 W WILLIAM CANNON DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491923",
            "telephone_number": "737-260-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RDG WILLIAM CANNON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "LIGHTFOOT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "214-702-0708"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rose Dental Group William Cannon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rose Dental Group William Cannon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.