NPIMap

Organization Active NPI

Russell W. Cannon DDS Apc

  • Dental Clinic/Center
  • Irvine, CA
National Provider Identifier
1912544768
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RUSSELL W. CANNON DDS APC
Practice address
14150 Culver Dr Ste 200
Irvine, CA 92604-0322
Phone
(949) 552-7874
NPI assigned
Nov 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Authorized official

Name
Dr. Russell Wayne Cannon, D.D.S.NPI 1649387986
Title
President/Owner
Phone
(949) 552-7874

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

14150 Culver Dr Ste 200
Irvine, CA 92604-0322

Mailing address

14150 Culver Dr Ste 200
Irvine, CA 92604-0322
Phone (949) 552-7874

National Provider Directory

National Provider Directory

Locations

14150 Culver Dr
Ste 200
Irvine, CA 92604
Phone (949) 552-7874

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1912544768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040322",
            "telephone_number": "949-552-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040322",
            "telephone_number": "949-552-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL W. CANNON DDS APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "949-552-7874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.