DR. GRANT B. CANNON D.D.S., M.D.
NPI 1467678938
Dentist - Oral and Maxillofacial Surgery in Salt Lake City, UT

Q: What is Grant Cannon's NPI number?

The NPI number for Grant Cannon is 1467678938. It was assigned to this individual provider in the NPPES registry on April 17, 2007.

Q: What is Grant Cannon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Grant Cannon was last updated on November 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 17, 2007PECOS Enrolled

4190 HIGHLAND DR, SUITE 112, SALT LAKE CITY, UT 84124(801) 272-9241(801) 277-9760 Get Directions Write a Review

NPPES record last updated: November 11, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Grant B. Cannon D.d.s., M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GRANT B. CANNON D.D.S., M.D. (NPI 1467678938) is an individual oral and maxillofacial surgery provider in Salt Lake City, Utah, licensed in Utah (133953) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467678938

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. GRANT B. CANNONCredential: D.D.S., M.D.

Location Address4190 HIGHLAND DR, SUITE 112Salt Lake City, UT 84124-2600

Mailing Address4190 Highland Dr, Suite 112Salt Lake City, UT 84124-2600 · (801) 272-9241 · Fax (801) 277-9760

Phone(801) 272-9241

Fax(801) 277-9760

Sole ProprietorNo

Enumeration DateApril 17, 2007

Last NPPES UpdateNovember 11, 2021

NPPES CertifiedNovember 11, 2021

✔ NPI 1467678938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in UT · 133953

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

4190 HIGHLAND DR, Salt Lake City, UT 84124

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Grant B. Cannon D.d.s., M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Grant Cannon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Adult Services

3.4 mi

Neurology

175 N MEDICAL DR
Salt Lake City, UT 84132

Reassigned Medicare billing, Utah enrollment
2,620 clinicians in this Medicare group

NPI 1578967345 (801) 585-7575

University Of Utah Dental Services

5.3 mi

Dental

530 S WAKARA WAY
Salt Lake City, UT 84108

Reassigned Medicare billing, Utah enrollment
20 clinicians in this Medicare group

NPI 1821446279 (801) 587-6453

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LINDA C GURRISTER LCSW

Social Worker (Clinical)

4190 HIGHLAND DR, SUITE 210
SALT LAKE CITY, UT 84124

Salt Lake County (801) 278-8492

DR. DOUGLAS BURGOYNE PHARMD, RPH

Pharmacist

4190 HIGHLAND DR, SUITE 250
SALT LAKE CITY, UT 84124

Salt Lake County (801) 865-1997

BRUCE K JACOBSON PH D P C

Clinic/Center (Adult Mental Health)

4190 HIGHLAND DR, SUITE 211
SALT LAKE CITY, UT 84124

Salt Lake County (801) 272-0614

KARL E SEASHORE M.S., L.P.C.

Counselor (Professional)

4190 HIGHLAND DR, SUITE 211
SALT LAKE CITY, UT 84124

Salt Lake County (801) 272-0613

MR. JEFFREY RALPH GRANT L.C.S.W.

Social Worker (Clinical)

4190 HIGHLAND DR, SUITE 210
SALT LAKE CITY, UT 84124

Salt Lake County (801) 274-0403

DR. JAN ELLEN KADERABEK BURTON PH.D.

Psychologist (Clinical)

4190 HIGHLAND DR
SALT LAKE CITY, UT 84124

Salt Lake County (801) 274-0403

DR. KATHLEEN STROMAN KING PHD

Psychologist

4190 HIGHLAND DR, SUITE 210
SALT LAKE CITY, UT 84124

Salt Lake County (801) 943-7897

KARL E SEASHORE, LPC, PC

Counselor (Professional)

4190 HIGHLAND DR, SUITE 211
SALT LAKE CITY, UT 84124

Salt Lake County (801) 272-0613

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grant Cannon's NPI number?

The NPI number for Grant Cannon is 1467678938. It was assigned to this individual provider in the NPPES registry on April 17, 2007.

Where is Grant Cannon located?

Grant Cannon practices at 4190 Highland Dr Suite 112, Salt Lake City, UT 84124. The listed phone number is (801) 272-9241.

What is Grant Cannon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Grant Cannon enrolled in Medicare?

Yes. Grant Cannon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Grant Cannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Grant Cannon reassigns Medicare benefits to 2 organizations: University Of Utah Adult Services (Salt Lake City, UT) and University Of Utah Dental Services (Salt Lake City, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Grant Cannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Grant Cannon accept?

Health plans from Molina Healthcare list Grant Cannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grant Cannon was last updated on November 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.