ALEXANDER BANNOUT (NPI# 1255419446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255419446 |
| Entity Type | Individual |
| Full Name | ALEXANDER BANNOUT |
| Credential | DDS |
| Practice Address |
130 Canal St Suite 204 Pooler GA 31322-4085 |
| Practice Telephone | 9127485868 |
| Practice Fax Number | 9127486778 |
| Mailing Telephone | 9127485868 |
| Mailing Fax Number | 9127486778 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
2901019341 | MI | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN013382 | GA | Dental Providers |
| Street Address |
130 CANAL ST SUITE 204 |
| City | POOLER |
| State | GA |
| Zip Code | 31322-4085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821451709 | Danielle Carter | Behavioral Analyst | 130 Canal St, Suite 403, Pooler, GA 31322-4085 | 2016-03-30 |
| 1568857506 | Affinis Hospice, LLC | Hospice Care, Community Based | 130 Canal St, Suite 102 & 103, Pooler, GA 31322-4085 | 2015-04-06 |
| 1780934893 | Randall Crum Inc. | Clinic/Center | 130 Canal St, Ste. 601, Pooler, GA 31322-4085 | 2012-09-17 |
| 1316204498 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 130 Canal St, Suite 601, Pooler, GA 31322-4085 | 2012-04-13 |
| 1619249042 | Costrini & Meadows, PC | Internal Medicine | 130 Canal St, Suite 601, Pooler, GA 31322-4085 | 2012-02-01 |
| 1053606798 | Jaime Melinda Watkins-gillham | Behavioral Analyst | 130 Canal St, Building 400, Pooler, GA 31322-4085 | 2011-06-10 |
| 1982917522 | Alexander Bannout Dds, PC | Dentist | 130 Canal St, Suite 204, Pooler, GA 31322-4085 | 2010-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427518745 | Quinate Pharmacy LLC | Pharmacy | 1557 Pooler Pkwy, Suite 400, Pooler, GA 31322 | 2019-03-22 |
| 1396202495 | Rucker Holdings | Durable Medical Equipment & Medical Supplies | 210 Grand Central Blvd, Pooler, GA 31322 | 2019-02-25 |
| 1306301841 | Altamaha Dme, Inc | Durable Medical Equipment & Medical Supplies | 1557 Pooler Parkway, Suite 300, Pooler, GA 31322 | 2019-02-08 |
| 1750859351 | Bombery Chiropractic LLC | Chiropractor | 122 Canal St. Ste 109, Pooler, GA 31322 | 2018-11-13 |
| 1407347891 | Georgia Dental Professionals, PC | Dentist | 2140 Pooler Pkwy, Pooler, GA 31322 | 2018-05-22 |
| 1730685439 | Monali Patel | Optometrist | 276 Pooler Pkwy Ste B, Pooler, GA 31322 | 2018-04-02 |
| 1144747023 | Publix Super Markers, Inc | Durable Medical Equipment & Medical Supplies | 101 Blue Moon Crossing, Pooler, GA 31322 | 2017-08-23 |
| 1063932408 | The Range Physical Therapy, LLC | Clinic/Center | 10801 County Line Rd, Madison, AL 31322 | 2017-06-27 |
| 1285154427 | Pooler Physical Therapy LLC | Clinic/Center | 101 Shepherd Way, Pooler, GA 31322 | 2017-06-20 |
| 1578009130 | Georgia Cvs Pharmacy L.l.c | Durable Medical Equipment & Medical Supplies | 500 Pooler Pkwy, Pooler, GA 31322 | 2017-01-06 |
| Find all providers in zip 31322 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407347891 | Georgia Dental Professionals, PC | Dentist | 2140 Pooler Pkwy, Pooler, GA 31322 | 2018-05-22 |
| 1760937668 | Gamble Dentalsmart, PC | Dentist | 1034 Us Highway 80 W, Pooler, GA 31322-2114 | 2016-08-20 |
| 1114304540 | Gamble Dentalsmart PC | Dentist | 1034 Highway 80, Pooler, GA 31322 | 2015-05-06 |
| 1396135216 | Georgia Dental Professionals, PC | Dentist | 155 Trader Way, Pooler, GA 31322 | 2015-01-30 |
| 1811013402 | Julia K Howard | Dentist | 91 Brighton Woods Dr, Pooler, GA 31322-2141 | 2007-03-22 |
| 1164498507 | Shana K Herring | Dentist | 143 Canal St Ste 400, Suite #2, Pooler, GA 31322-6016 | 2006-02-26 |
| 1477048155 | Dimple Jayantilal Patel | Dentist | 276 Pooler Pkwy Ste A, Pooler, GA 31322-5163 | 2018-06-26 |
| 1457794190 | Colin Trester Strub | Dentist | 125 Southern Junction Blvd, Suite 701, Pooler, GA 31322-2214 | 2013-04-11 |
| 1053696781 | Towne Lake Dental Group, LLC | Dentist | 125 Southern Junction Blvd, Suite 701, Pooler, GA 31322-2214 | 2011-10-13 |
| 1982917522 | Alexander Bannout Dds, PC | Dentist | 130 Canal St, Suite 204, Pooler, GA 31322-4085 | 2010-07-25 |
| Find all providers in POOLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.