DR. RUSSELL WAYNE CANNON D.D.S.
NPI 1649387986
Dentist - General Practice in Irvine, CA

Q: What is Russell Cannon's NPI number?

The NPI number for Russell Cannon is 1649387986. It was assigned to this individual provider in the NPPES registry on August 24, 2006.

Q: What is Russell Cannon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: Is Russell Cannon enrolled in Medicare?

No. Russell Cannon has opted out of Medicare through March 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Russell Cannon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 August 24, 2006Opted out of Medicare · through Mar 1, 2027

14150 CULVER DR STE 200, IRVINE, CA 92604(949) 552-7874(949) 552-7047 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Russell Wayne Cannon D.d.s. NPPES

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

DR. RUSSELL WAYNE CANNON D.D.S. (NPI 1649387986) is an individual general practice provider in Irvine, California, licensed in California (D24279) and active in the NPI registry since August 2006. He has opted out of Medicare through March 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1649387986

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. RUSSELL WAYNE CANNONCredential: D.D.S.

Location Address14150 CULVER DR STE 200Irvine, CA 92604-0322

Mailing Address14150 Culver Dr Ste 200Irvine, CA 92604-0322 · (949) 552-7874 · Fax (949) 552-7047

Phone(949) 552-7874

Fax(949) 552-7047

Sole ProprietorYes

Enumeration DateAugust 24, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1649387986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · D24279

Definition

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.

14150 CULVER DR STE 200, Irvine, CA 92604

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Russell Wayne Cannon D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 1, 2017 through March 1, 2027.

Opt-Out Effective DateMarch 1, 2017

Opt-Out In Effect ThroughMarch 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92604 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

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

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

RUSSELL W. CANNON DDS APC

Clinic/Center (Dental)

14150 CULVER DR STE 200
IRVINE, CA 92604

Orange County (949) 552-7874

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 Russell Cannon's NPI number?

The NPI number for Russell Cannon is 1649387986. It was assigned to this individual provider in the NPPES registry on August 24, 2006.

Where is Russell Cannon located?

Russell Cannon practices at 14150 Culver Dr Ste 200, Irvine, CA 92604. The listed phone number is (949) 552-7874.

What is Russell Cannon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Russell Cannon enrolled in Medicare?

No. Russell Cannon has opted out of Medicare through March 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Russell Cannon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.