DR. MARK SMITH CANNON (NPI# 1083813810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083813810 |
| Entity Type | Individual |
| Full Name | DR. MARK SMITH CANNON |
| Credential | D.M.D. |
| Practice Address |
3400 Arapahoe Ave Boulder CO 80303-1023 |
| Practice Telephone | 3034442129 |
| Practice Fax Number | 3034138145 |
| Mailing Telephone | 3034442129 |
| Mailing Fax Number | 3034138145 |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 9352 | CO | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891731121 | Mark L Cannon | Dentist | 4160 Rfd, Grove Medical Center, Suite 308, Long Grove, IL 60047-9583 | 2006-06-22 |
| 1366881369 | Mark James Cannon | Health Educator | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2013-06-24 |
| 1407162936 | Mark James Cannon | Optometrist | 2602 Ne University Village St, Suite B (at Market Optical), Seattle, WA 98105-5023 | 2010-08-21 |
| 1306035381 | Mark Cannon | Psychiatry & Neurology | 230 Central Park W, New York, NY 10024-6029 | 2007-10-16 |
| 1881805265 | Mark Lawrence Cannon | Internal Medicine | 1854 W Auburn Rd, Suite 200, Rochester Hills, MI 48309-3868 | 2007-05-25 |
| 1720169295 | Mark Cannon | Psychiatry & Neurology | 3801 Blue Pkwy, Kansas City, MO 64130-2807 | 2006-10-18 |
| 1942211131 | Mark A. Cannon | Anesthesiology | 3626 Ruffin Rd, San Diego, CA 92123-1810 | 2006-08-11 |
| 1215991484 | Mark Andrew Cannon | Physician Assistant | 100 Emancipation Dr, Department of Surgery, Hampton, VA 23667-0001 | 2006-04-14 |
| Street Address |
3400 ARAPAHOE AVE |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-1023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508063280 | Boulder Dental Patners LLP | Dentist | 3400 Arapahoe Ave, Boulder, CO 80303-1023 | 2007-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583725 | Ariel Meyers | Physical Therapist | Frasier Meadows Retirement Community Dept. of Rehab, 350 Ponca Place, Boulder, CO 80303 | 2018-06-25 |
| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144709494 | Mercy Blalock | Dentist | 1840 Folsom St Ste 201, Boulder, CO 80302-5712 | 2018-08-08 |
| 1194242206 | Sage Dentisty IIi Pllc | Dentist | 4150 Darley Ave Ste 7, Boulder, CO 80305-6537 | 2017-08-29 |
| 1568817898 | Carmen Alicia Burke | Dentist | 877 E Moorhead Cir, C, Boulder, CO 80305-6119 | 2016-04-23 |
| 1114309135 | Alleman Family Dental PC | Dentist | 2551 31st St, Boulder, CO 80301-6119 | 2015-06-25 |
| 1568854271 | Jana A. Ikeda, Dds, PC | Dentist | 805 S Broadway St Ste 210, Boulder, CO 80305-5972 | 2015-03-04 |
| 1396150710 | Whitney Kitchell Smith | Dentist | 2700 Canyon Blvd, Ste 210, Boulder, CO 80302 | 2014-06-24 |
| 1144501453 | Thomas S Wolff | Dentist | 3056 Edison Ct, Boulder, CO 80301 | 2011-08-31 |
| 1972831709 | Peter Neilson Jeppsen | Dentist | 2500 30th St Ste 204, Boulder, CO 80301-1258 | 2009-12-07 |
| 1437484623 | Paul D'amore | Dentist | 7020 Baseline Rd, Boulder, CO 80303-3141 | 2009-10-06 |
| 1235362864 | Darren Rennaker | Dentist | 4300 Arapahoe Ave, Boulder, CO 80303 | 2009-08-31 |
| Find all providers in BOULDER | ||||
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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.