Kahala C Cannon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8044 Issued in TN

Practice address

5366 Mendenhall Mall
Memphis, TN 38115-4505

Phone

(901) 271-6156

Fax

(901) 271-6195

NPI assigned

Oct 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1770573131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 CENTRAL AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045905",
            "telephone_number": "901-271-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5366 MENDENHALL MALL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381154505",
            "telephone_number": "901-271-6156",
            "fax_number": "901-271-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "KAHALA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3497809",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anja Cannon
• Blair Boeving Cannon, CRNA
• Carrie Cannon, RBT
• John Clark Cannon, LMSW
• John Shrader Cannon, D.D.S.
• Kirsten Cannon, MS, LPC-MHSP, NCC
• Tyler Austin Cannon, M.D.
• Tara Canova, PTA
• Melissa Canterbury, LMFT
• Laura Cantrell, MS, RDN, LDN

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.