Dr Grant B Cannon, DDS, MD in Salt Lake City, UT

Dr Grant B Cannon, DDS, MD is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in Salt Lake City, Utah. His current practice location is 4190 Highland Dr, Suite 112, Salt Lake City, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 272-9241.

Dr Grant B Cannon is licensed to practice in Utah (license number 133953) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1467678938.

Contact Information

	Dr Grant B Cannon, DDS, MD
	4190 Highland Dr, Suite 112, Salt Lake City, UT 84124-2600
	(801) 272-9241
	(801) 277-9760

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Grant B Cannon
Gender	Male
Speciality	Dentist - Oral And Maxillofacial Surgery
Location	4190 Highland Dr, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1467678938
Provider Enumeration Date: 04/17/2007
Last Update Date: 11/11/2021

Medicare PECOS Information:

PECOS PAC ID: 4486084639
Enrollment ID: I20200430002171

Medical Identifiers

Medical identifiers for Dr Grant B Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467678938	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223S0112X	Dentist - Oral And Maxillofacial Surgery	133953 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Grant B Cannon allows following entities to bill medicare on his behalf.

Entity Name	University Of Utah Adult Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683

Entity Name	University Of Utah Dental Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346633203 PECOS PAC ID: 0244542595 Enrollment ID: O20150630001141

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Grant B Cannon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Grant B Cannon, DDS, MD 4190 Highland Dr, Suite 112, Salt Lake City, UT 84124-2600 Ph: (801) 272-9241	Dr Grant B Cannon, DDS, MD 4190 Highland Dr, Suite 112, Salt Lake City, UT 84124-2600 Ph: (801) 272-9241

Reviews and Comments

Dentist in Salt Lake City, UT

Dr. Adam Richard Van Leeuwen, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 6936 South 2475 East, 201, Salt Lake City, UT 84121 Phone: 801-943-1612 Fax: 801-942-6008
Robert Kellen Mcwhorter, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 440 W 200 S Ste 275, Salt Lake City, UT 84101 Phone: 801-358-8175
Victor O Pickett, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 5255 S 4015 W, Suite 180, Salt Lake City, UT 84118 Phone: 801-968-9003
Kelly D Carroll, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2114 Fort Union Blvd, Salt Lake City, UT 84121 Phone: 801-943-2020
Dr. Oscar Daniel Bluth, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 515 S 1000 E, Suite L-2 West, Salt Lake City, UT 84102 Phone: 801-370-0050
Dr. Michael Reed Slater, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 500 Foothill Blvd, Salt Lake City, UT 84148 Phone: 801-584-1206
Nielson Kirk Ashton, DMD Dentist Medicare: Medicare Enrolled Practice Location: 2180 E 4500 S Ste 250, Salt Lake City, UT 84117 Phone: 801-272-8609

Dr Grant B Cannon, DDS, MD - Medicare Dentist in Salt Lake City, UT