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Active NPI 1982917522 Organization (Entity Type 2)

Alexander Bannout Dds, Pc

Dentist - General Practice • Pooler, GA

About Alexander Bannout Dds, Pc NPI 1982917522 Summary

Alexander Bannout Dds, Pc is a verified healthcare organization specializing in Dentist - General Practice operating in Pooler, GA. Located at 130 CANAL ST, SUITE 204, this facility provides patient care and medical services under National Provider Identifier (NPI) 1982917522.

Administrative operations and authorized compliance are overseen by Alexander Bannout (Dentist).

The facility is associated with 3 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

130 Canal St
Suite 204

Pooler, GA 313224085

Telephone 9127485868
Fax 9127486778

Authorized Official Information

Authorized Contact Name

DR. Alexander Bannout , DDS

Title / Role

Dentist

Official Telephone

2488907347

Facility Classifications & Specialties

Dentist - General Practice Primary Taxonomy

NUCC Taxonomy Code: 1223G0001X

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.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

3 Linked

Behavior Analyst

Pooler, GA

View Practitioner Profile →

Dentist - General Practice

Pooler, GA

View Practitioner Profile →
Danielle Carter NPI 1821451709

Behavior Analyst

Pooler, GA

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active July 25, 2010

NPI status registered as active in NPPES database

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Updated Practice Location July 25, 2010

Registered at 130 CANAL ST, SUITE 204, POOLER, GA 313224085 (Tel: 9127485868)

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Updated Business Mailing Address July 25, 2010

Registered at 130 CANAL ST, SUITE 204, POOLER, GA 313224085 (Tel: 9127485868)

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Organization / Clinic Name Updated July 25, 2010

Operating as ALEXANDER BANNOUT DDS, PC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2010

Dentist (License #DN013382 in GA)

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Initial NPI Registration & Enumeration July 25, 2010

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1982917522
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 25, 2010
Last Update: July 25, 2010

Mailing Address

130 Canal St, Suite 204

Pooler, GA 313224085

Phone: 9127485868

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.