NPIMap

Organization Active NPI

Prime Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Newport News, VA
National Provider Identifier
1104663962
Registry record updated Jul 10, 2024
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
220 Nat Turner Blvd S
Newport News, VA 23606-2998
Phone
(757) 240-5711
Fax
(757) 240-4939
NPI assigned
Jul 10, 2024
Last updated
Jul 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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) 869-9916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

220 Nat Turner Blvd S
Newport News, VA 23606-2998

Mailing address

3120 Kiln Creek Pkwy
Yorktown, VA 23693-5648
Phone (757) 327-4843

Other practice location 1

5000 Foundation St
Williamsburg, VA 23188-2872
Phone (757) 259-9703

Other practice location 2

6750 Main St
Gloucester, VA 23061-5143
Phone (804) 695-2575

National Provider Directory

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

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1104663962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 KILN CREEK PKWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236935648",
            "telephone_number": "757-327-4843",
            "fax_number": "757-234-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062998",
            "telephone_number": "757-240-5711",
            "fax_number": "757-240-4939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Foundation St",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231882872",
            "country_code": "US",
            "telephone_number": "757-259-9703",
            "fax_number": "757-259-9715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6750 Main St",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "VA",
            "postal_code": "230615143",
            "country_code": "US",
            "telephone_number": "804-695-2575",
            "fax_number": "804-695-2815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "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": "757-869-9916"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.