Active NPI
William Norman Prillaman II, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Forest, VA
National Provider Identifier
1417030180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 0401008100
- Practice address
- 306 Brook Park Place
Forest, VA 24551 - Phone
- (484) 385-4499
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0401008100 | VA | Primary |
Addresses
Primary practice location
306 Brook Park Place
Forest, VA 24551
Mailing address
306 Brook Park Place
Forest, VA 24551
Phone (434) 385-4499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9178723 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401008100 | VA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1417030180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 BROOK PARK PLACE",
"city": "FOREST",
"state": "VA",
"postal_code": "24551",
"telephone_number": "434-385-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 BROOK PARK PLACE",
"city": "FOREST",
"state": "VA",
"postal_code": "24551",
"telephone_number": "484-385-4499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRILLAMAN",
"first_name": "WILLIAM",
"middle_name": "NORMAN",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "VA",
"license": "0401008100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9178723",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.