Reed F Cannon, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DD2899 Issued in NM

Practice address

106 A Longview Dr
Los Alamos, NM 87544-3738

Phone

(505) 672-1336

Fax

(505) 672-0840

NPI assigned

Jul 17, 2007

Last updated

Jul 17, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• High Mesa Dental Arts

  • Dentist
  • Los Alamos, NM
  • NPI 1518163583
  NPD (past)

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1801095062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 A LONGVIEW DR",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443738",
            "telephone_number": "505-672-1336",
            "fax_number": "505-672-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 A LONGVIEW DR",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443738",
            "telephone_number": "505-672-1336",
            "fax_number": "505-672-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "REED",
        "middle_name": "F",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Ann Bubenzer, FNP
• Lauren Bucklin
• Sara Elise Bulthuis
• Camryn Bussell
• Tatiana Canning
• Canyon Path Counseling LLC
• Sharon Cape, PHARM D
• Robert James Carbone, M.D.
• Care First LLC
• Christine Carlos, MD

• Dentist in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.