Cannon Johnson, DMD
Dentist, General Practice in Columbia, SC. Individual provider (NPI-1).
NPI number1003733007
StatusActive
Last updated in NPPESJul 1, 2026
Details
- NPI
- 1003733007
- Entity type
- Individual (NPI-1)
- Name
- Cannon Johnson
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2026
- Certification date
- Jul 1, 2026
- Last updated
- Jul 1, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D-00237 | KY | Yes |
Practice location
4323 Champion Hill StColumbia, SC 29207-6022
Phone 803-751-6213
Mailing address
4050 Beverly Hills DrPegram, TN 37143-2206
Phone 615-779-3091
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