Provider Demographics
NPI:1093605271
Name:CANNON, PIPER (DDS)
Entity type:Individual
Prefix:
First Name:PIPER
Middle Name:
Last Name:CANNON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14207 TUSCAN SUN CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-6108
Mailing Address - Country:US
Mailing Address - Phone:918-978-1312
Mailing Address - Fax:
Practice Address - Street 1:5150 MAE ANNE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1858
Practice Address - Country:US
Practice Address - Phone:775-747-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8221122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist