DR. MICHAEL LAWRENCE GANNON D.M.D.
NPI 1316096480
Dentist - Periodontics in Vienna, VA

Q: What is Michael Gannon's NPI number?

The NPI number for Michael Gannon is 1316096480. It was assigned to this individual provider in the NPPES registry on January 9, 2007.

Q: What is Michael Gannon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: Is Michael Gannon enrolled in Medicare?

No. Michael Gannon has opted out of Medicare through June 22, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Michael Gannon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 09, 2007Opted out of Medicare · through Jun 22, 2027

138 CHURCH ST NE, VIENNA, VA 22180(703) 938-6022(703) 938-6039 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Michael Lawrence Gannon D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL LAWRENCE GANNON D.M.D. (NPI 1316096480) is an individual periodontics provider in Vienna, Virginia, licensed in Virginia (6214) and active in the NPI registry since January 2007. He has opted out of Medicare through June 22, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1316096480

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. MICHAEL LAWRENCE GANNONCredential: D.M.D.

Location Address138 CHURCH ST NEVienna, VA 22180-4543

Mailing Address138 Church St NeVienna, VA 22180-4543 · (703) 938-6022 · Fax (703) 938-6039

Phone(703) 938-6022

Fax(703) 938-6039

Sole ProprietorYes

Enumeration DateJanuary 9, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1316096480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in VA · 6214

Definition

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.

138 CHURCH ST NE, Vienna, VA 22180

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Michael Lawrence Gannon D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 22, 2015 through June 22, 2027.

Opt-Out Effective DateJune 22, 2015

Opt-Out In Effect ThroughJune 22, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22180 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HOWARD THOMAS LENZ JR. DDS

Dentist (General Practice)

138 CHURCH ST NE
VIENNA, VA 22180

Fairfax County (703) 938-6669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Gannon's NPI number?

The NPI number for Michael Gannon is 1316096480. It was assigned to this individual provider in the NPPES registry on January 9, 2007.

Where is Michael Gannon located?

Michael Gannon practices at 138 Church St NE, Vienna, VA 22180. The listed phone number is (703) 938-6022.

What is Michael Gannon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Michael Gannon enrolled in Medicare?

No. Michael Gannon has opted out of Medicare through June 22, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Michael Gannon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.