DR. KAHALA C CANNON (NPI# 1770573131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770573131 |
| Entity Type | Individual |
| Full Name | DR. KAHALA C CANNON |
| Credential | DDS |
| Practice Address |
5366 Mendenhall Mall Memphis TN 38115-4505 |
| Mailing Address |
2595 Central Ave Memphis TN 38104-5905 |
| Practice Telephone | 9012716156 |
| Practice Fax Number | 9012716195 |
| Mailing Telephone | 9012716300 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2013-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
8044 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3497809 | 05 |
| Street Address |
5366 MENDENHALL MALL |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38115-4505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497208177 | Gina Sabbatini | Physician Assistant | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2016-07-28 |
| 1295288983 | Sarah Shuler | Physician Assistant | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2016-07-28 |
| 1811356645 | Annalyse Faulk | Physician Assistant | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2016-02-22 |
| 1003236217 | Christina Brown Tran | Family Medicine | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2014-04-27 |
| 1114347366 | Tessa Denzin | Physician Assistant | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2014-04-25 |
| 1417398553 | Shawna Clark | Dentist | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2013-07-16 |
| 1154764397 | Ana Patricia Carasusan | Pediatrics | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2013-04-08 |
| 1326307596 | Katherine G Barger | Pediatrics | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2012-05-09 |
| 1992062517 | Maria Del Carmen Fernandez | Family Medicine | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2012-04-19 |
| 1518238450 | Rachel L Faller | Nurse Practitioner | 5366 Mendenhall Mall, Memphis, TN 38115-4505 | 2012-01-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891315370 | Janell Lennice C Jackson | Pharmacist | 3670 Riverdale Road, Memphis, TN 38115 | 2020-04-24 |
| 1982246393 | A.y Nunley | Technician | 5614 Crepe Myrtle Drive, Memphis, TN 38115 | 2019-10-17 |
| 1114580776 | Dee's Around The Clock | Home Health Aide | 6099 Apple Tree Suite35, Optional, Memphis, TN 38115 | 2019-04-19 |
| 1679047476 | Demetria S Summers | Home Health | 6099 Appletree, Suite35, Memphis, TN 38115 | 2019-01-15 |
| 1134698590 | Patriot Healthcare of Tennessee, LLC | Family Medicine | 3175 Lenox Park Boulevard, Suite 100, Memphis, TN 38115 | 2018-11-15 |
| 1891293106 | Decrese A Beverly | Counselor | 5405 Fox Plaza Dr # 108g, Memphis, TN 38115 | 2018-02-01 |
| 1720597289 | Frank A Taylor Jr. | Nutritionist | 6061 Hickory Ridge Mall Ste. 452, Memphis, TN 38115 | 2017-09-27 |
| 1255717260 | Mary L Avery | Social Worker | 5563 Knight Arnold Rd., Memphis, TN 38115 | 2015-08-03 |
| 1104207166 | Good Shepherd Medication Management | Pharmacy | 6052 Hickory Ridge Mall Ste 148, Memphis, TN 38115 | 2015-06-16 |
| 1265811665 | Good Shepherd Health | Pharmacy | 6052 Hickory Ridge Mall, Suite 148, Memphis, TN 38115 | 2015-05-19 |
| Find all providers in zip 38115 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497361596 | Crosstown Dental Group Highland Row LLC | Dentist | 431 S Highland St Ste 115, Memphis, TN 38111-1633 | 2020-09-23 |
| 1922626019 | Randy Bagay | Dentist | 1350 Concourse Ave Ste 446, Memphis, TN 38104-2026 | 2020-07-06 |
| 1780200279 | Taylor Rae Vracar | Dentist | 875 Union Ave Ste 301, Memphis, TN 38103-3513 | 2020-06-19 |
| 1063982957 | Jasmine Copelanddds | Dentist | 1251 Wesley Dr Ste 130, Memphis, TN 38116-6443 | 2018-12-04 |
| 1770075681 | Bellano East Memphis, Pllc | Dentist | 5336 Estate Office Dr Ste 1, Memphis, TN 38119-3623 | 2018-06-06 |
| 1992200364 | Lauren Alyssia Henderson | Dentist | 5180 Park Ave Ste 210, Memphis, TN 38119-3530 | 2018-03-28 |
| 1598123986 | James F Proctor Dds Pa | Dentist | 1655 International Drive, Suite 203, Memphis, TN 38120-1436 | 2016-02-01 |
| 1497140008 | Tennessee Dental Professionals PC | Dentist | 6425 N Quail Hollow Rd Ste 102, Memphis, TN 38120-1438 | 2015-03-31 |
| 1255760385 | Tennessee Dental Professionals PC | Dentist | 370 Colonial Road, 3, Memphis, TN 38117 | 2013-11-08 |
| 1457793929 | Acadia Helath LLC | Dentist | 1000 Ridgeway Loop Rd, Suite 203, Memphis, TN 38120-4045 | 2013-07-24 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.