Colton Cannon

Dentist · La Grange Park, IL

Individual Active NPI

NPI number 1801590807

Practice location

539 N La Grange Rd
La Grange Park, IL 60526-5647
Phone
(708) 354-1070

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NPI record

NPI
1801590807
Entity type
Individual (Type 1)
Enumeration date
March 27, 2023
Last updated
July 9, 2026
Certified
July 9, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019.035872 IL

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238

About Colton Cannon

Colton Cannon is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 539 N La Grange Rd, La Grange Park, IL 60526-5647. The NPI number 1801590807 was assigned on March 27, 2023 and the record was last updated on July 9, 2026.

Colton Cannon lists a license in the registry: #019.035872 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Colton Cannon?

The NPI number is 1801590807.

What is the phone number of Colton Cannon?

The phone number listed for the practice location is (708) 354-1070.

Where is Colton Cannon located?

539 N La Grange Rd, La Grange Park, IL 60526-5647.

What is the taxonomy code for Colton Cannon?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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