Michael Lawrence Gannon, D.M.D.

Periodontics · Vienna, VA

Individual Active NPI

NPI number 1316096480

Practice location

138 Church St NE
Vienna, VA 22180-4543
Phone
(703) 938-6022
Fax
(703) 938-6039

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NPI record

NPI
1316096480
Entity type
Individual (Type 1)
Enumeration date
January 9, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Periodontics Primary 1223P0300X 6214 VA

About Dr. Gannon

Michael Lawrence Gannon, D.M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Periodontics (code 1223P0300X). The practice location is 138 Church St NE, Vienna, VA 22180-4543. The NPI number 1316096480 was assigned on January 9, 2007 and the record was last updated on July 8, 2007.

Dr. Gannon lists a license in the registry: #6214 (VA) for Periodontics. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Lawrence Gannon, D.M.D.?

The NPI number is 1316096480.

What is the phone number of Dr. Gannon?

The phone number listed for the practice location is (703) 938-6022.

Where is Dr. Gannon located?

138 Church St NE, Vienna, VA 22180-4543.

What is the taxonomy code for Dr. Gannon?

The primary taxonomy code is 1223P0300X – Periodontics.

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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