NPIMap

Organization Active NPI

Prime Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Centreville, VA
National Provider Identifier
1073482576
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
PRIME ORTHODONTICS PLLC
Practice address
14701 Lee Hwy
Ste 107-108
Centreville, VA 20121
Phone
(757) 869-9916
Fax
(757) 898-4919
NPI assigned
Nov 3, 2025
Organization subpart
Yes
Parent organization
PRIME ORTHODONTICS PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Chris Cannon
Title
RCM
Phone
(757) 869-9916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

14701 Lee Hwy
Ste 107-108
Centreville, VA 20121

Mailing address

3120 Kiln Creek Pkwy Ste 9
Yorktown, VA 23693-5648
Phone (757) 869-9916

National Provider Directory

National Provider Directory
Tax ID family
Prime Orthodontics PLLC8 organizations share this tax ID, including this one
Part of
Prime Orthodontics PLLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3120 Kiln Creek Pkwy
Ste 9
Yorktown, VA 23693

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1073482576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 KILN CREEK PKWY STE 9",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236935648",
            "telephone_number": "757-869-9916",
            "fax_number": "757-898-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 LEE HWY",
            "address_2": "STE 107-108",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "20121",
            "telephone_number": "757-869-9916",
            "fax_number": "757-898-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ORTHODONTICS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME ORTHODONTICS PLLC",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "757-869-9916"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.