MEDICARE: DR. RUSSELL RICH CANNON JR. DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6526	NV

General Provider Information

NPI Number	:	1306254446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSSELL RICH CANNON JR. DMD

Provider Business Mailing Address
First Line	:	2045 VILLAGE CENTER CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6251
Country	:	US
Telephone Number	:	702-878-5599
Fax Number	:	702-878-0173

Provider Business Practice Location Address
First Line	:	2045 VILLAGE CENTER CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6251
Country	:	US
Telephone Number	:	702-878-5599
Fax Number	:	702-878-0173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	07/31/2014

Similar Medicare Providers

1457347304 — SANA SAFAEI M.D.
Practice Location Address:

2035 VILLAGE CENTER CIR STE 110
LAS VEGAS, NV
89134-6251

Practice Phone: 702-228-7117
Practice Fax: 702-804-5365

1083604102 — HIMA B. ILLINDALA MD
Practice Location Address:

2035 VILLAGE CENTER CIR , SUITE 110
LAS VEGAS, NV
89134-6251

Practice Phone: 702-228-7117
Practice Fax: 702-804-5365

1144279282 — MARLENE SCHWARTZER M.D.
Practice Location Address:

2035 VILLAGE CENTER CIR , 111
LAS VEGAS, NV
89134-6251

Practice Phone: 702-228-7117
Practice Fax: 702-804-5365

1780636639 — DR. TODD SEARLE MILNE DDS
Practice Location Address:

2085 VILLAGE CENTER CIR , SUITE 120
LAS VEGAS, NV
89134-6251

Practice Phone: 702-240-5437
Practice Fax: 702-240-5436

1972814093 — SEJAL A DUGGAL MD
Practice Location Address:

2035 VILLAGE CENTER CIR # 110
LAS VEGAS, NV
89134-6251

Practice Phone: 702-228-7117
Practice Fax: 702-804-5365

1003216698 — WAGNER DENTAL LLC
Practice Location Address:

2045 VILLAGE CENTER CIR
LAS VEGAS, NV
89134-6251

Practice Phone: 702-878-5599
Practice Fax: 702-878-0173

Directions to “ DR. RUSSELL RICH CANNON JR. DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.