Provider Demographics
NPI:1942281787
Name:CANNON, JAMES JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CANNON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4209
Mailing Address - Country:US
Mailing Address - Phone:828-697-7500
Mailing Address - Fax:828-697-7507
Practice Address - Street 1:401 6TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4209
Practice Address - Country:US
Practice Address - Phone:828-697-7500
Practice Address - Fax:828-697-7507
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7916122300000X, 1223D0001X, 1223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health
No1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry