Individual provider Active NPI

Christopher Michael Bannon, D.M.D., MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Hoover, AL
National Provider Identifier
1063857589
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
6094 Issued in AL
Practice address
2036 Patton Chapel Rd
Hoover, AL 35216-5770
Phone
(205) 979-9738
Fax
(205) 979-9760
NPI assigned
May 10, 2013
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6094 AL
Student in an Organized Health Care Education/Training Program 390200000X
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 6094 AL Primary

Addresses

Primary practice location

2036 Patton Chapel Rd
Hoover, AL 35216-5770

Mailing address

2036 Patton Chapel Rd
Hoover, AL 35216-5770
Phone (205) 979-9738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190727000261 AL Practitioner - Oral Surgery 1052551702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
University of Alabama School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS. Koslin and Kahn, P.C.Group PAC ID 6305869371, 4 clinicians

Practice addresses (Care Compare)

2036 Patton Chapel Rd
Hoover, AL 35216-5770
Phone (205) 979-9738

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6094ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Koslin & Kahn, P.C. CurrentSince Feb 19, 2023 Accepting new patients
DRS. Koslin & Kahn, P.C. CurrentSince Oct 10, 2022 Accepting new patients
Madison Oral and Facial Surgery, LLC PastSince Jun 15, 2019 Accepting new patients

Locations

2036 Patton Chapel Rd
Hoover, AL 35216
Phone (205) 979-9738

1206 Highway 78 E
Jasper, AL 35501
Phone (205) 221-9190

1208 Highway 78 E
Jasper, AL 35501
Phone (205) 221-2733

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1063857589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 PATTON CHAPEL RD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352165770",
            "telephone_number": "205-979-9738",
            "fax_number": "205-979-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 PATTON CHAPEL RD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352165770",
            "telephone_number": "205-979-9738",
            "fax_number": "205-979-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNON",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "D.M.D., MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6094",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "6094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.