Organization Active NPI

Portsmouth Pediatric Dentistry PLLC

  • Dental Clinic/Center
  • Portsmouth, VA
National Provider Identifier
1043008089
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PORTSMOUTH PEDIATRIC DENTISTRY PLLC
Practice address
446 Effingham St Ste 400
Portsmouth, VA 23704-3464
Phone
(757) 397-9801
Fax
(757) 397-9805
NPI assigned
Apr 29, 2025
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Chris L Cannon
Title
RCM
Phone
(757) 397-9801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

446 Effingham St Ste 400
Portsmouth, VA 23704-3464

Mailing address

446 Effingham St Ste 400
Portsmouth, VA 23704-3464
Phone (757) 397-9801

Other names 1

  • FFPD Other name

National Provider Directory

National Provider Directory

Locations

446 Effingham St
Ste 400
Portsmouth, VA 23704
Phone (757) 397-9801

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1043008089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 EFFINGHAM ST STE 400",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043464",
            "telephone_number": "757-397-9801",
            "fax_number": "757-397-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 EFFINGHAM ST STE 400",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043464",
            "telephone_number": "757-397-9801",
            "fax_number": "757-397-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTSMOUTH PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "757-397-9801"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FFPD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.