NPIMap

Organization Active NPI

Brendon E. Prestwich, PLLC

Doing business as Super Smiles 4 Kids

  • General Practice Dentistry
  • Portsmouth, VA
National Provider Identifier
1194592717
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BRENDON E. PRESTWICH, PLLC
Doing business as
Super Smiles 4 Kids
Practice address
6224 Portsmouth Blvd Ste 300
Portsmouth, VA 23701-1351
Phone
(757) 500-8500
NPI assigned
Dec 4, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Dr. Brendon Prestwich, DDSNPI 1700134459
Title
President
Phone
(505) 358-8681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

6224 Portsmouth Blvd Ste 300
Portsmouth, VA 23701-1351

Mailing address

1370 Little Neck Rd
Virginia Beach, VA 23452-4719
Phone (505) 358-8681

Other names 1

  • Super Smiles 4 Kids Doing business as

National Provider Directory

National Provider Directory

Locations

6224 Portsmouth Blvd
Ste 300
Portsmouth, VA 23701
Phone (757) 337-0451

Practitioners & affiliated clinicians

Practitioners 3

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": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1194592717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 LITTLE NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524719",
            "telephone_number": "505-358-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6224 PORTSMOUTH BLVD STE 300",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237011351",
            "telephone_number": "757-500-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDON E. PRESTWICH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "PRESTWICH",
        "authorized_official_first_name": "BRENDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-358-8681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Smiles 4 Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 4, 2023; 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.