DR. MICHAEL LAWRENCE GANNON (NPI# 1316096480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316096480 |
Entity Type | Individual |
Full Name | DR. MICHAEL LAWRENCE GANNON |
Credential | D.M.D. |
Practice Address |
138 Church St Ne Vienna VA 22180-4543 |
Practice Telephone | 7039386022 |
Practice Fax Number | 7039386039 |
Mailing Telephone | 7039386022 |
Mailing Fax Number | 7039386039 |
Enumeration Date | 2007-01-09 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
6214 | VA | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033623111 | Michael James Gannon | Pharmacist | 833 S Wood St Fl 3, Chicago, IL 60612-7229 | 2017-11-27 |
1962809699 | Michael Walsh Gannon | Counselor | 109 Cloud Touch Ct, Roseville, CA 95747-7116 | 2014-11-24 |
1225441215 | Michael Gannon | Family Medicine | 2531 Landmark Dr Ste 103, Clearwater, FL 33761-3928 | 2014-06-06 |
1194086041 | Michael Patrick Gannon | Internal Medicine | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2012-06-06 |
1366582710 | Michael J Gannon | Internal Medicine | 2741 Wheaton Way, Bremerton, WA 98310-3344 | 2007-02-07 |
1790704856 | Michael Kevin Gannon | Orthopaedic Surgery | 2979 Squalicum Pkwy, Suite #203, Bellingham, WA 98225-1811 | 2006-07-19 |
1528060654 | Michael James Gannon | Family Medicine | 11452 Space Center Blvd, Houston, TX 77059 | 2005-08-10 |
Street Address |
138 CHURCH ST NE |
City | VIENNA |
State | VA |
Zip Code | 22180-4543 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255334199 | Howard Thomas Lenz Jr. | Dentist | 138 Church St Ne, Vienna, VA 22180-4543 | 2005-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023519386 | Erika Ruiz | Dentist | Ave Miraflores #6439 - A, Tijuana, BAJA CALIFORNIA 22180 | 2018-02-22 |
1992220206 | John Alexander | Massage Therapist | 122 Maple Ave W, Vienna, VA 22180 | 2017-08-08 |
1548620214 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 2675 Avenir Place, Vienna, VA 22180 | 2016-02-24 |
1992163190 | Peter J Mcgarry | Chiropractor | 301 Maple Ave. W. Ste 515, Vienna, VA 22180 | 2016-02-02 |
1629479563 | Jaimie Vettichira Samuel | Pediatrics | 100 East St Se Ste 301, Vienna, VA 22180 | 2014-09-10 |
1326454562 | N R Emad Dds PC | Dentist | 307 F Maple Ave. W #100, Vienna, VA 22180 | 2014-07-09 |
1881020568 | Albert Juan Garcia | Obstetrics & Gynecology | 926 Fairway Dr., N.e., Vienna, VA 22180 | 2013-09-25 |
1295174662 | Sallie Twentyman | Social Worker | 129 Park St Ne Ste 12b, Vienna, VA 22180 | 2013-06-19 |
1124390992 | Gilda T. Clarke | Counselor | 133 Park St. Ne, Vienna, VA 22180 | 2012-02-08 |
1740573898 | Metro Eyes LLC | Technician/Technologist | 256 E Maple Avenue, Vienna, VA 22180 | 2011-05-24 |
Find all providers in zip 22180 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588898266 | Keren Sperling | Dentist | 303 Maple Ave W Ste H, Vienna, VA 22180-4312 | 2009-05-08 |
1154409506 | Jennifer Hilario Diaz | Dentist | 8230 Boone Blvd Ste 410, Vienna, VA 22182-2646 | 2006-11-02 |
1609283373 | Ronald M Rosenberg | Dentist | 8308 Old Courthouse Rd, Vienna, VA 22182-3863 | 2014-07-15 |
1194935601 | Michael Vincent Farr | Dentist | 301 Maple Ave W, Suite A, Vienna, VA 22180-4308 | 2007-05-23 |
1346258266 | Farideh Iravani | Dentist | 1964 Gallows Rd, Suite 220, Vienna, VA 22182-3814 | 2006-08-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497361471 | Lisa A. Marvil, D.m.d., P.l.l.c. | Dentist | 17341-b Pickwick Drive, Purcellville, VA 20132 | 2020-09-16 |
1720624307 | Deena Hadithi Dmd, PC. | Dentist | 7210 Old Keene Mill Rd Ste 3, Springfield, VA 22150-3442 | 2019-11-19 |
1689223836 | Alka Panwar | Dentist | 4319 Dale Blvd Ste 6, Woodbridge, VA 22193-2401 | 2019-09-10 |
1801445135 | Neha Agarwal | Dentist | 23386 Epperson Sq, Brambleton, VA 20148-5794 | 2019-09-09 |
1164999181 | Smba Dentistry, Pllc | Dentist | 2801 Mcrae Rd Ste C1, North Chesterfield, VA 23235-3056 | 2018-10-29 |
1750860516 | Khashayar Kordbacheh Changi | Dentist | 3543 W Braddock Rd Ste E2, Alexandria, VA 22302-1903 | 2018-08-11 |
1205314309 | Shivangi B Amin | Dentist | 2420 Old Brick Rd Apt 1315, Glen Allen, VA 23060-5995 | 2018-07-31 |
1881107100 | New River Periodontics and Dental Implant Center, PC | Dentist | 2612 Sheffield Drive, Blacksburg, VA 24060 | 2017-11-08 |
1740793355 | Amy Ton Dds Pllc | Dentist | 11868 Sunrise Valley Dr Ste 100, Reston, VA 20191-3320 | 2017-11-06 |
1023539301 | Denver James Lyons | Dentist | 521 N 11th St # 980566, Richmond, VA 23298-5045 | 2017-06-27 |
Find all providers with the same taxonomy |
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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.